A rotating biological contactor (RBC) is a type of attached-growth biological wastewater treatment system and a widely used biological wastewater treatment technology. It employs a series of rotating discs to support microbial growth and promote the removal of pollutants from wastewater. RBC is widely recognized for its simplicity of design, high reliability, and low energy consumption. It has been used in various applications, from small-scale decentralized systems to large municipal wastewater treatment plants. The current review provides an overview of RBC bioreactors, design parameters, and the factors that influence biological performance, such as hydraulic retention time, sludge retention time, organic loading rate, disc rotational speed, and temperature. The review also highlights the advantages and disadvantages of RBCs compared with other wastewater treatment technologies and discusses their role in sustainable environmental performance. The future prospects of RBC are also discussed, including integration with other technologies, such as membrane filtration and potential use in resource recovery. The review explores the application of RBC in decentralized wastewater treatment and the potential to provide sustainable solutions for wastewater management in rural and remote areas. Overall, RBC remains a promising option for effective and efficient wastewater treatment, particularly in situations where simplicity, reliability, and low energy consumption are desired.