The management of domestic wastewater in rural areas has always been challenging due to characteristics such as the wide distribution and dispersion of rural households. There are numerous domestic sewage discharge methods used in rural areas, and it is difficult to treat the sewage. To address this problem, decentralized wastewater treatment systems (DWTSs) have been installed around the globe to reuse and recycle wastewater for non-potable uses such as firefighting, toilet flushing, and landscape irrigation. This study compares the currently implemented treatment processes by investigating them from the point of view of their performance and their advantages and disadvantages to provide new ideas for the development of rural wastewater treatment technologies. According to conventional treatment technologies including activated sludge (OD, A/O, A/A/O, SBR), biofilm (biofilter, MBBR, biological contact oxidation, biofluidized bed) and biogas digesters, natural biological treatment technologies including artificial wetlands (surface flow, vertical flow, horizontal submerged flow artificial wetlands), soil percolation systems (slow, fast, subsurface percolation and surface diffusion) and stabilization pond technology and combined treatment technologies are categorized and further described.