The drainage network passing through Kurunegala city collects wastewater from the city and a part of it is diverted to irrigate paddy fields. Wastewater supplies a major portion of the irrigation demand. This study assessed the problems associated with utilization and management of wastewater in Kurunegala city. Several studies have been conducted to identify wastewater utilization and management related issues such as health, sanitation and hygiene and water quality. Poorly managed wastewater has created many health problems such as high incidences of filariasis and dengue fever, skin defects, and bad odour. None availability of adequate water supply and sanitary facilities for low income communities has created very poor sanitary conditions, further pollution of the drains and disease spreading. Lack of interest and support among the authority and the community on infrastructure and facilities development for these communities is a major concern in wastewater management. This is aggravated by poor knowledge and attitudes and poor resource management and resource scarcity among the communities.