Quorum sensing (QS) plays an important role in microbial aggregation control. Recently, the optimization of biological waste treatment systems by QS regulation gained an increasing attention. The effects of QS regulation on treatment performances and biofilm were frequently investigated. To understand the state of art of QS regulation, this review summarizes the methods of QS enhancement and QS inhibition in biological waste treatment systems. Typical QS enhancement methods include adding exogenous QS molecules, adding QS accelerants and cultivating QS bacteria, while typical QS inhibition methods include additions of quorum quenching (QQ) bacteria, QS-degrading enzymes, QS-degrading oxidants, and QS inhibitors. The specific improvements after applying these QS regulation methods in different treatment systems are concluded. In addition, the effects of QS regulation methods on biofilm in biological waste treatment systems are reviewed in terms of biofilm formation, extracellular polymeric substances production, microbial viability, and microbial community. In the end, the knowledge gaps in current researches are analyzed, and the requirements for future study are suggested.