This chapter comprehensively overviews the legal and policy frameworks governing sewage treatment and sludge management. Beginning with a historical perspective and tracing the evolution to modern management techniques, the chapter addresses the challenges posed by increasing urbanization and population growth, which have significantly escalated sewage generation rates. Key regulations and frameworks, including water policy legislation, national urban sanitation policy, and state sewerage management policies, are meticulously examined. The chapter explains various sewage treatment techniques, detailing their processes and efficacy. Emphasis is placed on international guidelines, permissible limits, standards, penalties, and compliance requirements essential for effective management. Additionally, the chapter highlights critical gaps in current policies and suggests measures for addressing these shortcomings to ensure robust and sustainable sewage management systems. Overall, this chapter function as a foundational asset for policymakers, researchers, and practitioners involved in environmental management, offering insights into the regulatory landscape and technological advancements crucial for mitigating the challenges associated with sewage treatment and sludge management in contemporary urban settings.