This scientific review delves into the crucial role of wastewater reuse in agriculture for sustainable water resource management, especially in the context of water scarcity. The paper examines innovative wastewater treatment methods like biofiltration, membrane bioreactors, and electrocoagulation, exploring their effectiveness and limitations. It emphasizes the significance of proper wastewater treatment in mitigating risks and maximizing benefits. Key considerations such as economic viability and social acceptance are highlighted, urging comprehensive cost-benefit analyses and active engagement with stakeholders. Drawing from case studies in Tshwane, Egypt, Valencia, and Sde Warburg, successful wastewater reuse practices underscore the importance of stringent water quality standards, public education, regulatory frameworks, and stakeholder involvement in achieving sustainable wastewater management. Despite global advancements, challenges persist in the adoption of these technologies in many African countries, necessitating collaborative efforts and targeted capacity-building for widespread implementation. Historical insights reveal the evolution of wastewater irrigation from European and American cities to its current global prevalence, impacting around 10% of the world’s irrigated land with untreated or partially treated wastewater. Technological advancements, such as biofiltration relying on microbial activities, membrane bioreactors integrating biological treatment with filtration, and electrocoagulation as an electrochemical process, offer sustainable solutions. Case studies highlight the economic, environmental, and social benefits of successful wastewater reuse programs. However, the review acknowledges the risks associated with wastewater reuse, including environmental contamination and public health hazards. To strike a balance between risks and benefits, the paper advocates for proper wastewater treatment, robust regulatory frameworks, and responsible farming practices. It concludes by stressing the need for collaborative efforts, international partnerships, and targeted capacity-building initiatives to overcome barriers to the adoption of advanced wastewater treatment technologies in African countries, fostering water management, ensuring food security, and contributing to social and economic development amid global challenges.