Decentralized systems play a big role in wastewater treatment in rural areas. The aims of this study are to address the wastewater treatment and disposal problems for rural districts of Istanbul, to discuss the efficiencies of currently operated systems and to offer new appropriate wastewater treatment systems for small communities having a population up to 5,000. The management and final disposal alternatives for sludge generated in septic tanks are also discussed within the scope of this study. A sequencing batch reactor (SBR) system serving 2,500 people and a hybrid constructed wetland system serving 500 people are presented as case studies. A thorough evaluation based on the capacity and performance of the existing wastewater treatment systems in rural districts revealed that a number of these systems are not operating at their optimum. Improperly constructed sewer lines receive a lot of infiltration and inflow (I & I) after rainfall events, decreasing treatment performance and causing operational difficulties. Natural treatment systems such as constructed wetlands prove a viable alternative in these communities, especially for villages with populations less than 500 people.