With growing global concerns over sustainable wastewater treatment, there is a pressing need for low-cost, eco-friendly filtration solutions. This study conducted a life cycle assessment (LCA) to evaluate the potential of improving slow sand filtration efficiency by integrating alternative materials like clay and oyster shell powder (OSP), while minimizing the environmental footprint. Additionally, the adaptability of three-dimensional (3D) printing was explored to incorporate these materials into innovative filter designs, assessing scalability for broader wastewater applications. Ten filter configurations, including a slow sand filter (SSF) enhanced with OSP (90:10) and 3D-printed clay–OSP bricks (ratios of 90:10, 85:15, 80:20), were assessed across three sourcing distances: local (in situ), regional (161 km), and distant (1609 km). The results showed that SSFs with OSP consistently delivered lower environmental impacts, reducing freshwater ecotoxicity, eutrophication, and human toxicity by up to 4% compared to conventional SSFs, particularly when transport was minimized. Among brick-based systems, single-brick columns offered the best balance of performance and impact, while three-brick columns had the highest environmental burden, largely due to the increased electricity use. Economic analysis reinforced the environmental findings: SSFs with OSP were the most cost-effective option, followed closely by SSFs, while brick-based systems were slightly more expensive, with costs rising sharply when sourcing distances exceeded 161 km. Overall, integrating OSP into SSFs offers an optimal balance of sustainability and affordability, while single-brick columns (90:10) present a promising alternative. Future research should further optimize material blends and design configurations to align with long-term environmental and economic goals.

Global water scarcity has intensified over recent decades, with projections suggesting that nearly six billion people may face limited access to clean water by 2050. Water reuse has emerged as a viable strategy to alleviate pressure on freshwater resources, particularly for non-potable applications. However, safe implementation requires wastewater to be treated to meet fit-for-purpose quality standards established through regional and national regulatory frameworks. Despite high levels of basic sanitation coverage in high-income countries such as the United States, persistent gaps remain in affordable and equitable wastewater management, particularly in small and underserved communities. This review focused on current knowledge of sustainable low-cost materials, including plant-based, clay, and clay-based ceramics; animal-derived products; and industrial by-products, used to remove a broad range of contaminants, including heavy metals, dyes, nutrients, emerging contaminants, and pathogens, from wastewater. The mechanisms governing their performance, such as adsorption, coagulation–flocculation, and filtration, were examined alongside contaminant-specific performance. The review further highlights the emerging role of 3D printing in developing customizable, efficient, and scalable treatment units using low-cost or waste-derived materials. Life cycle assessment (LCA) studies were evaluated to highlight their role as a flexible framework for assessing environmental impacts across life-cycle stages and for guiding the selection of sustainable materials and treatment systems. Together, these perspectives provide a comprehensive foundation for developing decentralized, community-oriented wastewater treatment solutions that support safe and effective water reuse, especially in rural and small communities.