Sulfate-laden wastewater generated from various natural and industrial activities, including mining, metallurgy, electroplating, and battery manufacturing and recycling, has the potential to contaminate both ground and surface water bodies. It is harmful to all forms of life and the environment. Thus, developing an efficient treatment system to address sulfate pollution is necessary. Biological sulfate reduction (BSR) involving sulfate-reducing bacteria offers a better removal of sulfate than conventional physicochemical methods. BSR offers various advantageous such as lower sludge production, removal and recovery of metals, and production of elemental sulfur. However, the performance of bioreactors depends on wastewater sources, microbes involved, and operating conditions. Currently, limited studies are available encapsulating the current state of the art of biological sulfate remediation aimed at optimization of bioreactor design and operation. Therefore, this paper attempts to provide a comprehensive review of the sources of sulfate, its health and ecological effects, microbes involved in sulfate reduction, and its removal pathways that would be beneficial for future bioreactor design. In addition, theoretical and practical aspects of influencing factors have been discussed. Considering the results of the reviewed articles, operating, and set-up conditions are recommended to obtain the higher sulfate removal. It includes dissimilatory sulfate reduction by mixed bacterial culture using sodium lactate as an electron donor with pH near about neutral, mesophilic conditions, COD/SO2−4 ratio of 0.67-1.7, ORP less than −100 mV, and lesser sulfide concentration. This overview helps to develop an effective strategy for bioremediation of sulfate and decreasing the sulfate-rich industrial effluent footprint.