Human activities continue to affect our water quality; it remains a major problem worldwide (particularly concerning freshwater and human consumption). A critical water quality index (WQI) method has been used to determine the overall water quality status of surface water and groundwater systems globally since the 1960s. WQI follows four steps: parameter selection, sub-indices, establishing weights, and final index aggregation, which are addressed in this review. However, the WQI method is a prolonged process and applied to specific water quality parameters, i.e., water consumption (particular area and time) and other purposes. Therefore, this review discusses the WQI method in simple steps, for water quality assessment, based on two multi-criteria decision-making (MCDM) methods: (1) analytical hierarchical process (AHP); and (2) measuring attractiveness by a categorically based evaluation technique (MACBETH). MCDM methods can facilitate easy calculations, with less effort and great accuracy. Moreover, the uncertainty and eclipsing problems are also discussed—a challenge at every step of WQI development, particularly for parameter selection and establishing weights. This review will help provide water management authorities with useful knowledge pertaining to water usage or modification of existing indicators globally, and contribute to future WQI planning and studies for drinking, irrigation, domestic, and industrial purposes.