Escherichia coli and thermotolerant coliforms are of major importance as indicators of fecal contamination of water. Due to its negative surface charge and relatively low die-off or inactivation rate coefficient, E. coli is able to travel long distances underground and is therefore also a useful indicator of fecal contamination of groundwater. In this review, the major processes known to determine the underground transport of E. coli (attachment, straining and inactivation) are evaluated. The single collector contact efficiency (SCCE), eta0, one of two parameters commonly used to assess the importance of attachment, can be quantified for E. coli using classical colloid filtration theory. The sticking efficiency, alpha, the second parameter frequently used in determining attachment, varies widely (from 0.003 to almost 1) and mainly depends on charge differences between the surface of the collector and E. coli. Straining can be quantified from geometrical considerations; it is proposed to employ a so-called straining correction parameter, alpha(str). Sticking efficiencies determined from field experiments were lower than those determined under laboratory conditions. We hypothesize that this is due to preferential flow mechanisms, E. coli population heterogeneity, and/or the presence of organic and inorganic compounds in wastewater possibly affecting bacterial attachment characteristics. Of equal importance is the inactivation or die-off of E. coli that is affected by factors like type of bacterial strain, temperature, predation, antagonism, light, soil type, pH, toxic substances, and dissolved oxygen. Modeling transport of E. coli can be separated into three steps: (1) attachment rate coefficients and straining rate coefficients can be calculated from Darcy flow velocity fields or pore water flow velocity fields, calculated SCCE fields, realistic sticking efficiency values and straining correction parameters, (2) together with the inactivation rate coefficient, total rate coefficient fields can be generated, and (3) used as input for modeling the transport of E. coli in existing contaminant transport codes. Areas of future research are manifold and include the effects of typical wastewater characteristics, including high concentrations of organic compounds, on the transport of E. coli and thermotolerant coliforms, and the upscaling of experiments to represent typical field conditions, possibly including preferential flow mechanisms and the aspect of population heterogeneity of E. coli.