Most governments in developing countries do not invest enough to treat wastewater, therefore, the farmers use untreated wastewater for irrigation. The positive aspects of such irrigation are a reliable and year-round water source, little or no spending on fertilizer, less pumping cost than with groundwater, an increase in soil organic matter, and greater income from market-ready crops. The negative risks include imbalanced nutrient addition, salinity, metal ion contamination, emerging contaminants, and potential exposure of farmers and consumers to pathogens and contaminants. Balancing these tradeoffs requires ensuring positive outcomes while minimizing risks through wastewater treatment and use compatible with its quality.