In China, decentralized wastewater treatment is used to solve the problem of rural sewage. In this study, the primary types of decentralized processes applied to rural wastewater treatment are reviewed using typical case studies in China. In the past several years, as a result of recent policy directions and various economic factors, ecological technologies such as constructed wetlands and soil treatments have been developed. However, due to the lack of professional construction and appropriate management in rural areas, it has been difficult to establish a suitable system of effluent quality, technology selection and construction. Recently, the combination of biological and ecological processes in wastewater treatment has been brought into focus. It is urgent that a standard system of effluent quality, technology selection and construction is established. In addition to this, routing management is a significant factor to consider.