This comprehensive study delves into the critical issue of sewage management in the context of rapid urbanization and population growth, using Bangalore, India, as a case study. It highlights the detrimental impacts of water pollution caused by untreated domestic sewage and emphasizes the urgent need for efficient sewage treatment systems. The document outlines various challenges such as inadequate infrastructure, insufficient treatment capacities, and the detrimental effects on public health and the environment. It discusses the current status of wastewater management in Bangalore, including the existing treatment plants and water supply systems. Furthermore, the study explores different sewage treatment processes, ranging from conventional centralized systems to decentralized approaches. Each treatment method is analyzed in terms of its effectiveness, sustainability, and suitability for various applications, such as agriculture, industry, urban non-potable use, groundwater recharge, and environmental conservation. The review underscores the importance of implementing scientifically operated sewage treatment plants to ensure the availability of high-quality treated water for secondary purposes, reduce freshwater consumption, mitigate environmental degradation, and safeguard public health. It concludes by emphasizing the significance of selecting appropriate treatment technologies and adopting an integrated approach to sewage management to achieve sustainable development goals and long-term water security.