Substantial progress has been made providing wastewater service in urban areas in China over the past decades, resulting in essentially complete coverage for wastewater collection and treatment. In spite of rapid progress installing wastewater collection and treatment systems, China continues to be faced with the two principal components of the water crisis, namely, water pollution and water scarcity. In response, governmental policies are leading to investments supporting the rapid development of new technologies and approaches to integrated water/wastewater management. Investments in membrane technology development and manufacturers have led to widespread application of membrane technology and, contrasting with international practice, to the development of a significant indigenous manufacturing and delivery capacity. At the same time, lack of attention to collection systems has resulted in their poor condition leading to wastewater characteristics adversely impacting process performance and resource recovery opportunities. Recent policy actions are leading to correction of this situation. Biosolids management has lagged behind the develop of wastewater treatment capacity and is also adversely impacted by excessive loadings of inorganic materials due to the poor condition of some collection systems. Experience gained through significant investments in biosolids upgrades over the past 10 years has led to the development of four principal biosolids management strategies that are now being implemented. Building on the progress made addressing wastewater treatment needs in urban areas, attention is turning to rural areas where nearly 500 million people live. Two emerging water management paradigms, namely, integrated water management and resource recovery, are being implemented in China through The Concept Wastewater Treatment program and Sponge Cites. Wastewater management in China is progressing from the implementation of basic treatment, to the adoption and development of new technologies, and to the implementation of integrated solutions intended to achieve a broader range of outcomes including improved water quality, resource recovery, and increased livability. The results already being achieved, and to be anticipated in the future, will be of broad interest because of the magnitude of Chinese wastewater treatment, which allows a broad range of options to be evaluated.