In recent years, the research community has made constant efforts to develop new technologies for the recovery and valorization of water, nutrient and energy content of municipal wastewater. However, the recovery process is significantly limited due to the low-strength of sewage. Over the last 10 years, the Forward Osmosis (FO) process, has gained interest as a low-cost process with low membrane fouling propensity, which can convert municipal wastewater into a concentrated low-volume effluent, characterized by high organic and nutrient concentration. This chapter presents the main configurations that have been implemented for the concentration of municipal wastewater using FO, including their performance in terms of contaminant removal and water/reverse salt flux (Jw/Js). Furthermore, the draw solutions and respective concentrations that have been used in FO for the treatment of sewage are reported, while at the same time the positive and negative characteristics of each application are evaluated. Finally, in the last section of this chapter, the spontaneous FO followed by anaerobic process is integrated in a municipal wastewater treatment plant (WWTP) and compared with a conventional one. The comparison is done, in terms of the mass balance of the chemical oxygen demand (COD) and in terms of the energy efficiency.