Wastewater pollution problems are associated with population growth and the concentration of population in large urban centers. According to United Nations projections for 2050, the world population will reach 9 billion people, increasing the pressures on water resources due to their demand and pollution. Based on UNICEF and World Health Organization estimates, 2.4 billion people worldwide currently lack access to improved sanitation facilities, with 946 million practicing open defecation. Decentralized wastewater treatment systems are a viable and necessary alternative for wastewater management, thus, minimizing environmental impacts, facilitating resource recovery, and providing rural and peri-urban inhabitants with access to basic sanitation. This literature review article uses the multicriteria analysis tool to present the key economic, institutional, social, environmental, and technological aspects, criteria, and indicators that must be considered for successful decentralized system implementation planning to strengthen basic sanitation service coverage in the rural and peri-urban areas where it does not exist., Wastewater treatment systems; Decentralized systems; Multicriteria analysis; Centralization level; System resilience; Natural wastewater treatment technologies