In this chapter, wastewater (WW) generation and management plans in Sub-Saharan Africa (SSA) region were discussed. Generation rates in most countries were estimated at 0–10 m3 yr−1 while collection, treatment and reuse of WW was below 5% in most countries with exception of South Africa and Nigeria in some cases. Low generation rates were associated with limited monitoring on WW production in the region due to the lack of sewer connections and infrastructure and hence, underestimation using available data. The low rates of collection, treatment and reuse were attributable to the lack of financial, technological and human resources to manage the effluents and incorporate it in a circular economy. In the evaluated case studies, WW management was characterized by the overflow and discharge of raw sewage, low priority input to manage the resource by specific governments, privatization of WW and sanitation services and extensive pollution, public health and environmental concerns from the mismanagement of the resource. The need to manage WW sustainably was emphasized to reverse its associated negative effects.