The design of above ground building drainage systems follows codes and standards that only give cursory recognition to the fact that this system connects, in the majority of cases, directly to a vast network of sewer pipes leading to a wastewater treatment plant. At the same time, for underground systems, airflow within as well as in and out of sewers is often neglected during the design of sewers, which depend on these building installed systems for pressure relief and venting. There is clearly an interaction between the two systems, yet this is not reflected in the design guidance, particularly inside buildings where air pressure fluctuations can lead to the destruction of water trap seals and the ingress of foul air containing sewer gases and potentially harmful pathogens. In this systematic review of historical research and design practice for both above and belowground drainage systems, we present the current state of the art and make recommendations for advancements that recognise the interaction between systems and present a view on how design could be advanced in a more holistic way.