AbstractCities in developing countries are experiencing unparalleled growth and rapidly increasing water supply and sanitation coverage that will continue to release growing volumes of wastewater. In many developing countries, untreated or partially treated wastewater is used to irrigate the cities' own food, fodder, and green spaces. Farmers have been using untreated wastewater for centuries, but greater numbers now depend on it for their livelihoods and this demand has ushered in a range of new wastewater use practices. The diversity of conditions is perhaps matched only by the complexity of managing the risks to human health and the environment that are posed by this practice. An integrated stepwise management approach is called for, one that is pragmatic in the short- and medium terms, and that recognises the fundamental economic niche and users' perceptions of the comparative advantages of wastewater irrigation that drive its expansion in urban and peri-urban areas. Comprehensive management approaches in the longer term will need to encompass treatment, regulation, farmer user groups, forward market linkages that ensure food and consumer safety, and effective public awareness campaigns. In order to propose realistic, effective, and sustainable management approaches, it is crucial to understand the context-specific tradeoffs between the health of producers and consumers of wastewater-irrigated produce as well as the quality of soils and water, on the one hand, and wastewater irrigation benefits, farmers' perceptions, and institutional arrangements on the other. This introductory chapter to the current volume on wastewater use in agriculture highlights a series of tradeoffs associated with continued use of untreated wastewater in agriculture. Empirical results from the case studies presented in the volume shed light on devising workable solutions.