Excessive nutrient loading (considering nitrogen and phosphorus) is a major ongoing threat to water quality and here we review the impact of nutrient discharges from wastewater treatment plants (WWTPs) to United States (U.S.) freshwater systems. While urban and agricultural land uses are significant nonpoint nutrient contributors, effluent from point sources such as WWTPs can overwhelm receiving waters, effectively dominating hydrological characteristics and regulating instream nutrient processes. Population growth, increased wastewater volumes, and sustainability of critical water resources have all been key factors influencing the extent of wastewater treatment. Reducing nutrient concentrations in wastewater is an important aspect of water quality management because excessive nutrient concentrations often prevent water bodies from meeting designated uses. WWTPs employ numerous physical, chemical, and biological methods to improve effluent water quality but nutrient removal requires advanced treatment and infrastructure that may be economically prohibitive. Therefore, effluent nutrient concentrations vary depending on the particular processes used to treat influent wastewater. Increasingly stringent regulations regarding nutrient concentrations in discharged effluent, along with greater freshwater demand in populous areas, have led to the development of extensive water recycling programs within many U.S. regions. Reuse programs provide an opportunity to reduce or eliminate direct nutrient discharges to receiving waters while allowing for the beneficial use of reclaimed water. However, nutrients in reclaimed water can still be a concern for reuse applications, such as agricultural and landscape irrigation.