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The use of wastewater in agriculture and aquaculture has a long tradition throughout Asia. For example, in Hanoi, it creates important livelihood opportunities for >500,000 farmers in peri-urban communities. Discharge of domestic effluents pollute the water streams with potential pathogenic organisms posing a public health threat to farmers and consumers of wastewater-fed foodstuff. We determined the effectiveness of Hanoi's wastewater conveyance system, placing particular emphasis on the quality of wastewater used in agriculture and aquaculture. Between April and June 2014, a total of 216 water samples were obtained from 24 sampling points and the concentrations of total coliforms (TC), Escherichia coli, Salmonella spp. and helminth eggs determined. Despite applied wastewater treatment, agricultural field irrigation water was heavily contaminated with TC (1.3×10(7)colony forming unit (CFU)/100mL), E. coli (1.1×10(6)CFU/100mL) and Salmonella spp. (108 most probable number (MPN)/100mL). These values are 110-fold above Vietnamese discharge limits for restricted agriculture and 260-fold above the World Health Organization (WHO)'s tolerable safety limits for unrestricted agriculture. Mean helminth egg concentrations were below WHO tolerable levels in all study systems (<1egg/L). Hence, elevated levels of bacterial contamination, but not helminth infections, pose a major health risk for farmers and consumers of wastewater fed-products. We propose a set of control measures that might protect the health of exposed population groups without compromising current urban farming activities. This study presents an important example for sanitation safety planning in a rapidly expanding Asian city and can guide public and private entities working towards Sustainable Development Goal target 6.3, that is to improve water quality by reducing pollution, halving the proportion of untreated wastewater and increasing recycling and safe reuse globally., (Copyright © 2016. Published by Elsevier B.V.)