The present chapter seeks to inform policy interventions and induce transformative change toward a more sustainable and resilient urban future by highlighting the intersections of environment, technology, society, and health in the context of urban wastewater management. The increasing global water crisis has led to recognizing of wastewater as a resource. However, one of the main concerns is the looming threat of anti-microbial resistance (AMR) genes within wastewater, which poses a significant public health risk. Adopting a “One Health” approach, this chapter uses the secondary data—obtained from empirical studies and data from national and international agencies (e.g., WHO, Mo HFW, and Central Pollution Control Board)—to critically evaluate the status of wastewater management and the prevalence of infections from AMR microbes in India. The chapter links personal care product use and poor treatment facilities to the spread of AMR genes. It suggests improving wastewater reuse in India by overcoming technical, economic, and social obstacles. The widespread use of antimicrobial products is also contributing to the crisis by releasing residues into wastewater, helping to create resistant microbes. In conclusion, this chapter advocates for a paradigm shift toward a more holistic and integrated approach to urban water management, holding the principles of “One Health.” Understanding the interconnectedness of humans, animals, and the environment, a path toward resilient, flourishing, and sustainable urban environments can be charted.