Steady growth of population, due to overall population increases and continuing migration from rural to urban areas, creates enormous demands and stresses on urban waters with respect to water supply, drainage, flood protection, wastewater management, and beneficial uses of receiving waters and groundwater. Urban water issues are therefore in the forefront of water management priorities in practically all regions of the world, though often for broadly varying reasons. Key issues of urban water management are discussed in this article, which focuses on the evolution of urban drainage infrastructure, characterization of urban drainage, urban runoff impacts on receiving waters, urban drainage management, water, and wastewater reuse and future perspectives and priorities. The discussion focuses on the collection and transport of urban effluents (sewer systems), characterization of urban drainage provided by combined or storm sewers (flows and their quality), impacts of urban drainage effluents on receiving waters, and groundwater and impact mitigation by integrated urban drainage management with the emphasis placed on the management of surface runoff and water/wastewater reuse. While the progress in integrated engineering science, watershed‐based management and new water technologies is impressive, the challenges of maintaining and improving urban water services, particularly in low‐income countries, are formidable and may be further exacerbated by demographic, social, and climate change.