Since the beginning of the 1990s, local authorities in Israel have been engaged in promoting advanced Wastewater Treatment Plant (WWTP) projects throughout the country, resulting in the "wastewater treatment revolution" of the 1990s. These achievements are extremely important in the water-scarce country, as untreated or partially treated wastewater has become a major source of pollution of Israel's fresh-water resources, and reuse of high-quality effluents can expand the national water potential. Many of these projects are regional schemes based on a central WWTP, serving a few neighboring municipalities. This paper presents two case studies of such regional cooperation: the "Karmiel Region Union of Towns for Sewage Treatment" and the "Treatment and Reuse of Wastewater in the area of the Hadera Stream, Ltd." corporation. The findings suggest that regional cooperation can be an efficient tool in promoting advanced wastewater treatment, and has several advantages: an efficient use of limited resources (financial and land); balancing disparities between municipalities (size, socio-economic features, consciousness and ability of local leaders); and reducing spillover effects. However, some problems were reported in both cases and should be addressed.