Sewage treatment is the process of removing contaminants from municipal wastewater, containing mainly household sewage plus some industrial wastewater. Physical, chemical, and biological processes are used to remove contaminants and produce treated wastewater (or treated effluent) that is safe enough for release into the environment. A by-product of sewage treatment is a semi-solid waste or slurry, called sewage sludge. The sludge has to undergo further treatment before being suitable for disposal or application to land.

Sewage treatment may also be referred to as wastewater treatment. However, the latter is a broader term which can also refer to industrial wastewater. For most cities, the sewer system will also carry a proportion of industrial effluent to the sewage treatment plant which has usually received pre-treatment at the factories themselves to reduce the pollutant load. If the sewer system is a combined sewer then it will also carry urban runoff (stormwater) to the sewage treatment plant. Sewage water can travel towards treatment plants via piping and in a flow aided by gravity and pumps. The first part of filtration of sewage typically includes a bar screen to filter solids and large objects which are then collected in dumpsters and disposed of in landfills. Fat and grease is also removed before the primary treatment of sewage.

In highly regulated developed countries, industrial effluent usually receives at least pretreatment if not full treatment at the factories themselves to reduce the pollutant load, before discharge to the sewer. This process is called industrial wastewater treatment or pretreatment. The same does not apply to many developing countries where industrial effluent is more likely to enter the sewer if it exists, or even the receiving water body, without pretreatment. Industrial wastewater may contain pollutants which cannot be removed by conventional sewage treatment. Also, variable flow of industrial waste associated with production cycles may upset the population dynamics of biological treatment units, such as the activated sludge process.