Wastewater effluents are major contributors to a variety of water pollution problems. Most cities of developing countries generate on the average 30–70 mm3 of wastewater per person per year. Owing to lack of or improper wastewater treatment facilities, wastewater and its effluents are often discharged into surface water sources, which are receptacles for domestic and industrial wastes, resulting to pollution. The poor quality of wastewater effluents is responsible for the degradation of the receiving surface water body. Wastewater effluent should be treated efficiently to avert adverse health risk of the user of surface water resources and the aquatic ecosystem. The release of raw and improperly treated wastewater onto water courses has both short‐and long‐term effects on the environment and human health. Hence, there should be proper enforcement of water and environmental laws to protect the health of inhabitants of both rural and urban communities. This study reports major factors responsible for the failing state of wastewater treatment facilities in developing countries, which includes poor operational state of wastewater infrastructure, design weaknesses, lack of expertise, corruption, insufficient funds allocated for wastewater treatment, overloaded capacities of existing facilities, and inefficient monitoring for compliance, among others.