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There is a growing demand for integrating an assessment tool to select wastewater treatment alternatives based on sustainability in the Jordanian wastewater sector. The sector in Jordan has a unique and critical situation that has raised concerns among stakeholders, including donors, and international and national organizations, to carefully select a sustainable treatment system for each case. The Jordanian government set a tool to distinguish between treatment systems, and this tool is mainly focused on financial criteria. However, the sector needs to integrate assessment tools with a wider consideration of other sustainability criteria. Usually, stakeholders are not equipped with a clear methodology to perform sustainability assessments. Therefore, this study proposes and develops a Multi-Criteria Analysis (MCA) tool to evaluate wastewater treatment alternatives from a sustainability perspective for a case study in Jordan—Al Azraq town. Firstly, the study explored the decision and organizational context of the wastewater sector through several interviews. Secondly, assessment criteria and indicators were proposed to compare three proposed treatment alternatives. Finally, the Analytical Hierarchy Process (AHP) was applied with composite scores to evaluate wastewater treatment alternatives. Finally, The results of the composite scores indicated that French Constructed Wetland (FCW) was the best option for this case study, with a score of 3.13, followed by Stabilization Pond (SP) as the second sustainable option, with a score of 2.67, and lastly, Activated Sludge (AS), with a score of 2.07. Several conclusions have been highlighted during the process development, such as the importance of selecting sustainability indicators carefully, and engaging stakeholders during the design and implementation of the assessment.

About eighty percent of wastewater is discharged into the environment untreated. Many challenges are decelerating solving the global sanitation problem, such as the financial limitations and lack of technical capacities. Parallel to this, many countries are facing a growing demand on their limited water resources. Higher water demand and limited availability leads to over-abstraction and deterioration in the availability and quality water resources. In this situation, wastewater can be a new water source. Therefore, there is a growing interest in finding low-cost, easy-to-operate and sustainable sanitation solutions. Constructed wetlands (CWs) in recent years have proved their capability in the sanitation sector as an appropriate sanitation system in different contexts, CWs have proved their ability to treat several types of wastewaters for several decades. Several benefits and facts, such as the low construction and operational costs of CWs, low-energy, and less operational requirements, have raised the interests in CWs as a treatment technology. Several studies have investigated CWs suitability based on different sustainability indices (technical, social, environmental, etc.). In this paper, a comprehensive review covers the definition, types, treatment processes, sustainability criteria, limitations, and challenges of CWs. The paper also focuses on climate change resilience and circular economic approach under the technical and financial criteria, respectively.