There is a growing need for more sustainable wastewater treatment technologies to provide non-conventional water sources. Constructed Wetland systems (CW) are viewed as a low-cost treatment technology with proven treatment efficiency. CWS can treat a variety of contaminants using low energy and natural systems by altering various design parameters. There are two configuration types of constructed wetlands: vertical (VF) and horizontal flow CW (HF). Both configurations have been widely adopted in both large and pilot scale studies with proven records of reasonable wastewater treatment efficiency. The current article reviews the recent development of CW technology and highlights the main achievements and successful applications for wastewater treatment at various locations. The review has indicated that a considerable removal efficiency is attained while using engineered CW systems with variable treatment rates for various pollutants. The treatment efficiency is a function of various parameters including wastewater type, scale dimensions, applied plant and the retention time. The review compared the treatment efficiency for both VF and HF and has revealed that various removal rates of BOD, COD, TSS, TN, TP and NH₄ was attained using both configurations. Yet, the removal efficiency in the case of VF was slightly higher compared with the HF with an average treatment level of 77% and 68% was achieved in both systems, respectively. The review revealed that the CW is an effective and sustainable technology for wastewater treatment with the initial influent level, microbial biofilm, detention time, plant species and configuration among the most dominating parameters that are directly controlling the removal rates.