To employ technologies that sustainably harvest resources from wastewater (for example struvite granules shown here), new perceptions and infrastructure planning and design processes are required.Water and wastewater system decisions have been traditionally driven by considerations of function, safety, and cost-benefit analysis. The emphasis on costs and benefits would be acceptable if all relevant factors could be included in the analysis, but unfortunately many relevant factors are routinely excluded. Coupled with failures to fully engage the public in decision-making processes, this can impede progress toward achieving sustainable solutions. Ignoring broader social issues that impact the adoption of sustainable solutions prolongs not only global environmental and ecological problems, but also unjust public health and social conditions in the developing world.Within the water and wastewater management industry, discussions of sustainable development have often focused on water stress (1, 2): a hazard that is exacerbated by other global stressors such as climate change, demographic and land use changes, increasing population, and urbanization (2). In addition to water stress, water and wastewater management practices contribute to nutrient imbalances and a host of environmental detriments such as eutrophication (3), discharge of pharmaceuticals and other emerging contaminants (4), and a loss of biodiversity in receiving streams (5). Efforts to address these issues across regional and global scales are hindered by the historical disconnect between the water quality and water quantity factions of the water profession. Although our understanding of sustainability is constantly evolving, the water and wastewater design process retains its foundation in engineering traditions established in the early 20th century (6). As we chart a path in the 21st century, we contend that wastewater contains resources worthy of recovering and that the development of