Traditional wastewater research mainly focuses on 1) estimating the amount of waste entering sewage treatment facilities, 2) evaluating the treatment efficiency of sewage facilities, 3) investigating the role of sewage treatment effluent as a point source, and 4) designing and managing sewage treatment facilities. However, since wastewater contains a variety of chemical and biological substances due to the discharge of human excreta and material used for daily living into it, the collective constituents of wastewater are likely a reflection of a community’s status. Wastewater-based epidemiology (WBE), an emerging and promising field of study that involves the analysis of substances in wastewater, can be applied to monitor the state of a defined community. WBE provides opportunities for exploiting indicators in wastewater to fulfill various objectives. The data analyzed under WBE are those pertaining to selected natural and anthropogenic substances in wastewater that are a result of the discharge of metabolic excreta, illicit or legal drugs, and infectious pathogens into the wastewater. This paper reviews recent progress in WBE and addresses current challenges in the field. It primarily discusses several representative applications including the investigation of drug consumption across different communities and the management of community disease and health. Finally, it summarizes established indicators for WBE.