The increasing stress on lake ecosystems is affecting their functioning such as providing goods and services to inhabiting organisms and riparian communities. Monitoring of water quality is important for sustainable management and restoration of lake ecosystems. However, the costs associated with traditional approaches have become prohibitive while not giving reliable early warning signals on resource conditions. Therefore, the current shift in the use of bioindicators and multimetric indices (MMIs) in the monitoring of water quality is currently gaining global recognition with more emphasis on its application in lotic ecosystems. Therefore, this paper provides an elaborated insight into the application of macroinvertebrate-based MMIs in lentic ecosystems and the successes achieved so far. The various metrics and indices, the development strategies, application challenges, the use of macroinvertebrates as bioindicators, and the future projection of enhancing MMI usage in lentic environment monitoring particularly in developing countries are extensively covered. The use of MMI as a rapid lake biomonitoring tool needs to be adopted for sustainable applications in lake ecosystem management and as an integrated approach to monitoring human-induced stress especially in developing countries where there is a paucity of information.