The disposal of multifarious contaminants in water resources poses a grave threat to the environment and health. Effective methods of treating and detecting these contaminants are crucial for ensuring access to clean and safe water. MXenes and MXene-derived materials have emerged as promising candidates for the design and development of novel techniques for water purification and sensing applications, by virtue of their unique characteristics. These nanomaterials offer highly versatile features such as amenability for surface functionalization, tunability of interlayer spacing, good electrical conductivity, favorable ion transport properties, and large specific surface area. Considering their immense potential, research on MXene-based technologies for combating the water pollution problem is still in its early phase. This review provides a critical overview and evaluation of the recent advances in MXenes and MXene-based composites for the remediation and detection of water contaminants. The progress in the application of MXene-based materials in water treatment techniques such as membrane separations, photocatalysis, and adsorption is summarized. The developments in MXene-based sensors relying on electrochemical, fluorescent, colorimetric, electrochemiluminescence, and surface plasmon resonance approaches for the detection of water pollutants are discussed. The challenges and future prospects in MXene-derived water-related technologies are identified to facilitate their practical implementation.