Wastewater is a resource of increasing global importance, particularly in urban and peri-urban agriculture. Wastewater is used for crop production, which includes fodder grasses, vegetables, cereals, ornamental plants, trees and flowers, timber crops and fruit trees, as well as for aquaculture and is often the only source of irrigation available. Wastewater use for irrigation generates livelihoods for farmers, agricultural labourers, produce transporters, market brokers and produce vendors. Consumers also benefit by obtaining access to fresh and cheap produce due to low transportation costs. To prevent potential negative impacts on human health and the environment, the importance of wastewater reuse in urban and peri-urban agriculture has to be recognised and clear policy guidelines for reuse need to be established. Careful research and awareness raising needs to be stimulated. Women play a key role in this context both as producers and in food preparation. Wastewater use in urban, peri-urban agriculture is a cross-sectoral issue that requires a multi-sectoral and multi-actor approach to research and planning.