A survey of wastewater treatment facilities in the Federated States of Micronesia revealed a lack of fully functional treatment systems and conditions that potentially could lead to adverse environmental impacts and public health concerns. Due to inadequate facilities and equipment, the amount and composition of wastewater entering the plants as well as the degree of treatment being achieved is largely unknown. In some cases it appears raw sewage is being discharged directly into the ocean and excess sludge is regularly taken by local residents for agricultural purposes without adequate treatment. In addition, the need to establish best management practices for placement and maintenance of septic tanks is being sought after with a sense of urgency. Furthermore, treatment of wastewater from industrial and agricultural sources merits further attention in an effort to achieve ecofriendly solutions to current pollution problems. Comparisons of methods being used and problems encountered at different locations in the islands would provide valuable information to aid in the development of sustainable treatment practices throughout the region.