Back diffusion of contaminants from secondary sources may hamper site remediation if it is not properly addressed in the remedial design. A review of all reported technologies and strategies that have been or could be applied to address plume persistence due to back diffusion as published in the peer-reviewed literature is provided. We classify these into four major categories. The first category consists of those approaches that do not include active measures to specifically address contamination in the low permeable zones (LPZs) and can therefore be considered passive LPZ management approaches. A disadvantage of these approaches is the long duration that may be required to meet acceptable endpoints; however, this allows degradation to potentially play a significant part even at modest rates. The remaining three categories all use approaches to specifically address contaminants in the LPZ. The second category consists of strategies that promote contaminant destruction through the forward diffusion of amendments into the LPZ. A variety of laboratory tests indicate concentration or flux reductions range from no improvement, to reductions as high as four orders-of-magnitude depending on the evaluation metric. The third category consists of strategies that alter physical characteristics of the secondary source, and includes viscosity modification, fracturing, and soil mixing. Each of these offer unique advantages and are often used to deliver one or more amendments for contaminant treatment. The final category consists of thermal and electrokinetic remediation, both less susceptible to permeability contrast limitations. However, they are not routinely used for secondary-source treatment.