Water quality monitoring is one of the basic management approaches for aquatic ecosystems as it allows understanding of environmental health and sustainability. Macrophytes are part of freshwater ecosystems that have proven valuable as bioindicators because of their responsiveness and their ability to reflect changes in water quality. This chapter shows the potential of macrophytes in water quality assessment, as they can accumulate pollutants. They can be used to monitor changes in nutrient cycling and report ecological disturbances such as eutrophication and contamination due to heavy metals and organic pollutants. A systematic literature review of methodologies will draw attention to the precision and usefulness of macrophyte based approaches in different aquatic habitats. Case studies presented address the effectiveness of these methodologies in real-life applications. The chapter assesses cost-effectiveness, ecological integration and imposes constraints and challenges in implementation and considers the benefits and constraints against the backdrop of the state’s current macrophyte water management. It puts forward the implementation of monitoring strategies based on macrophytes within global frameworks.