Several groundwater vulnerability methodologies have been implemented throughout the years to face the increasing worldwide groundwater pollution, ranging from simple rating methodologies to complex numerical, statistical, and hybrid methods. Most of these methods have been used to evaluate groundwater vulnerability to nitrate, which is considered the major groundwater contaminant worldwide. Together with dilution, the degradation of nitrate via denitrification has been acknowledged as a process that can reduce reactive nitrogen mass loading rates in both deep and shallow aquifers. Thus, denitrification should be included in groundwater vulnerability studies and integrated into the various methodologies. This work reviewed the way in which denitrification has been considered within the vulnerability assessment methods and how it could increase the reliability of the overall results. Rating and statistical methods often disregard or indirectly incorporate denitrification, while numerical models make use of kinetic reactions that are able to quantify the spatial and temporal variations of denitrification rates. Nevertheless, the rating methods are still the most utilized, due to their linear structures, especially in watershed studies. More efforts should be paid in future studies to implement, calibrate, and validate user-friendly vulnerability assessment methods that are able to deal with denitrification capacity and rates at large spatial and temporal scales.