Objective: To characterize the situation of sanitary wastewater discharge in the hydrographic basins draining into the Baía da Ilha Grande (BIG) and to propose wastewater treatment alternatives based on the literature on decentralized solutions. Theoretical framework: The BIG has been experiencing negative environmental impacts due to the urbanization process in the region, mainly due to the irregular discharge of domestic wastewater into the environment. Method: The methodology was developed in two stages, with stage 1 involving data collection from available data in the 2017 Wastewater Atlas, and stage 2 focusing on identifying the most appropriate treatment technologies for this study from the fifteen options evaluated. Results and conclusion: The characterization revealed that municipalities within the BIG are already using decentralized solutions for domestic wastewater treatment, albeit below the national average coverage rates (18-54%). The five most promising technologies identified were Septic Tanks, Compact UASB, Biodigesters, Compartmentalized Anaerobic Reactors, and Integrated Biosystems. It is concluded that the communities have a sanitation deficit and show potential for implementing decentralized solutions. Implications of the research: The study helped develop strategies for decision-makers to select the most appropriate wastewater treatment technologies to meet local needs. It also served as a model for scientific studies in other locations. Originality/value: This study aligns with the Sustainable Development Goals (SDGs), particularly SDG 6, by presenting decentralized solutions as a promising pathway to universalizing household wastewater treatment in developing countries.