Groundwater recharge with reclaimed municipal wastewater presents a wide spectrum of technical and health challenges that must be carefully evaluated prior to undertaking a project. This review will provide a discussion of groundwater recharge and its management with special reference to health and regulatory aspects of groundwater recharge with reclaimed municipal wastewater. At present, some uncertainties with respect to health risk considerations have limited expanding use of reclaimed municipal wastewater for groundwater recharge, especially when a large portion of the groundwater contains reclaimed wastewater that may affect the domestic water supply. The proposed State of California criteria for groundwater recharge are discussed as an illustration of a cautious approach. In addition, a summary is provided of the methodology used in developing the World Health Organization's Guidelines for Drinking Water Quality to illustrate how numerical guideline values are generated for contaminants that may be applicable to groundwater recharge.