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Available as eBook only.This study, managed by the Water Environment Research Foundation (WERF) and funded by the U.S. EPA, identified the principal barriers that prevent engineers from giving equitable consideration to decentralized wastewater treatment options. The barriers were prioritized to determine which were the most influential and solvable, then strategies and actions were identified through which engineers can overcome the most influential barriers. While the barriers can seem daunting, it is important to keep in mind how much progress has been made. The decentralized wastewater treatment industry has become significantly more professional, many great examples of success exist, and knowledgeable champions of the decentralized field are sharing what they know in an effort to encourage the use of decentralized systems. With funding becoming more constrained nationally, and the funding gap for necessary wastewater infrastructure continually growing under the old centralized paradigm, the time may be right for new alternatives to gain traction. It will take hard and persistent work by many; however, that is the call of this study. If we each take on what we can and particularly if we each become champions for others, then the barriers will tumble and the wastewater issues faced by our communities will be solved by the best overall available solutions.