The development of a sustainable water quality monitoring system at national scale remains a big challenge until today, acting as a hindrance for the efficient implementation of the Water Framework Directive (WFD). This work provides valuable insights into the current state-of-the-art Earth Observation (EO) tools and services, proposing a synergistic use of innovative remote sensing technologies, in situ sensors, and databases, with the ultimate goal to support the European Member States in effective WFD implementation. The proposed approach is based on a recent research and scientific analysis for a six-year period (2017–2022) after reviewing 71 peer-reviewed articles in international journals coupled with the scientific results of 11 European-founded research projects related to EO and WFD. Special focus is placed on the EO data sources (spaceborne, in situ, etc.), the sensors in use, the observed water Quality Elements as well as on the computer science techniques (machine/deep learning, artificial intelligence, etc.). The combination of the different technologies can offer, among other things, low-cost monitoring, an increase in the monitored Quality Elements per water body, and a minimization of the percentage of water bodies with unknown ecological status.