Large scale centralised water, wastewater and stormwater systems have been implemented for over 100 years. These systems have provided a safe drinking water supply, efficient collection and disposal of wastewater to protect human health, and the mitigation of urban flood risk. The sustainability of current urban water systems is under pressure from a range of challenges which include: rapid population growth and resulting urbanisation, climate change impacts, and infrastructure that is ageing and reaching capacity constraints. To address these issues, urban water services are now being implemented with Integrated Urban Water Management (IUWM) and Water Sensitive Urban Design (WSUD) approaches. WSUD systems can deliver multiple benefits including water conservation, stormwater quality improvement, flood control, landscape amenity and a healthy living environment. These systems can be provided as stand-alone systems or in combination with centralised systems. These systems are still novel and thus face knowledge gaps that are impeding their mainstream uptake. Knowledge gaps cover technical, economic, social, and institutional aspects of their implementation. This paper is based on the outcomes of a comprehensive study conducted in South Australia which investigated impediments for mainstream uptake of WSUD, community perceptions of WSUD and potential of WSUD to achieve water conservation through the application of alternative resources, and in flood management. The outcomes are discussed in this paper for the benefit of water professionals engaged with WSUD planning, implementation, community consultation and regulation. Although the paper is based on a study conducted in South Australia, the comprehensive framework developed to conduct this detailed study and investigation can be adopted in any part of the world.