In drinking water treatment, filtration plays an important role in the multi-barrier approach employed for the removal of pathogens. The presence of suspended solids and other particulate matter in water increases the resistance of most microbes to disinfection. Therefore, high performance in the removal of particles achieved by granular filtration can increase the disinfection efficiency. Although sand is one of the major filter media, alternative media have been developed and used in recent years. In this review, the performance of alternative media is compared with traditional sand/anthracite for drinking water treatment. Advantages in the use of alternative media, especially glass media, have been found, including high filtration performance in removing residual particles and turbidity, minor modification requirements to the existing filtration configuration and slow head loss development. However, before the employment of them in industry, additional tests are recommended. In particular, full scale tests with variations in the operating conditions and analyses of pathogen removal should be performed. Moreover, this paper reviews the filtration processes and operating configurations which provide overall references to those who are studying and working in the field of water technology and treatment. In this paper, legislations/standards of safe drinking water are summarized as they are the driving force of developing new treatment technologies; mathematical modules for predicting the media filtration performance are briefed. Finally, future work on the application of alternative filter media is recommended.