The need for irrigated agriculture is growing day by day and the largest water withdrawals from renewable water resources are for irrigation. In addition, the available water resources are decreasing and we need to use non-conventional water resources for irrigation due to looming water crisis (Raschid-Sally and Jayakody, Drivers and characteristics of wastewater agriculture in developing countries: results from a global assessment. International Water Management Institute, Colombo, 35p, (IWMI Research Report 127), 2008). However, the volume of treating and using wastewater is limited due to the lack of adequate data and knowledge and/or negative effects of improper wastewater management (i.e. use of untreated wastewater). A comprehensive evaluation of what has been done is necessary in order to explore wastewater irrigation and to avoid trial-and-error policies. Although a study of wastewater irrigation from crops, soil, groundwater, health, irrigation equipments, modern technologies, and other environmental aspects is useful, management studies in comparison with other aspects can help lead to more reliable and more extensive fi ndings and fi nally a better decision on using wastewater for irrigation. The chapter presents challenges and prospects that may help decision making for the use of wastewater in irrigation.