The marine and coastal environment of the countries of the Western Indian is rich in biodiversity and associated natural resources that in some hotspot areas are already been stressed by discharge of wastewater from urban areas. The need for action to reduce stress on ecosystems by strengthening the regional legal basis for preventing land based sources of pollution, partly through development of capacity for sustainable development cannot be under emphasized. The Regional status report presents the findings of the review of municipal wastewater management approaches in the WIO Region. The report also examines the GPA Municipal wastewater management guideline and establishes their applicability in the WIO Region. The existing wastewater management policies and strategies in the WIO Region countries have been potential of resulting into significant changes in the way wastewater is managed and thus enhance public health and the integrity of the environment. The major problem, however, is the enforcement of policies, regulations and legislations. Wastewater management in the region is also hampered by weak institutional capacity, inadequate coordination and collaboration, unclear demarcation of responsibilities among various actors and low public awareness among the targeted communities. There is also a problem on the implementation and dissemination of policy and regulatory frameworks at all levels, particularly at the lower level close to beneficiaries (local communities, private sector, etc). Training and capacity building in local authorities with respect to attribution of ownership would considerably contribute to effective implementation of water and sanitation policies and associated legislation/regulations. Capacity building in the region is required for proper management of municipal wastewater.