<p>Urban land use change, driven by rapid global urbanization, represents a critical transformation of natural and agricultural landscapes into impervious surfaces, which fundamentally alters hydrological cycles and places severe stress on urban sewer systems. This comprehensive review synthesizes global evidence to examine the multifaceted impacts of urbanization on sewer system resilience, highlighting three core challenges: hydraulic overload, degradation of water quality, and increased urban flood risk. Through a systematic analysis of 179 studies and case studies from diverse regions—including megacities like New York, Seoul, and rapidly growing cities in the Global South such as Dhaka and Chattogram—the review demonstrates how impervious surface expansion exacerbates combined sewer overflows (CSOs), sanitary sewer overflows (SSOs), and pollutant transport. The study integrates original analytical dimensions, including a meta-analysis of hydraulic overload patterns across climate zones, a comparative evaluation of mitigation strategies such as green infrastructure and smart sewer technologies, and a conceptual framework linking urbanization intensity to infrastructure failure risks. Findings reveal that nature-based solutions (e.g., green roofs, clustered green spaces) and decentralized systems can reduce runoff by 30–60% and CSOs by up to 50%. At the same time, real-time monitoring technologies enhance proactive management. However, technological solutions alone are insufficient without supportive policy reforms, community engagement, and context-sensitive planning. The review concludes that integrated, adaptive strategies combining engineering innovations, sustainable urban planning, and stakeholder involvement are crucial for enhancing sewer system resilience, protecting water resources, and fostering sustainable urban environments in the face of ongoing urbanization and climate change.</p>