The need for cost-effective low-energy wastewater treatment has never been greater. Clean water for our expanding and predominantly urban global population will be expensive to deliver, eats into our diminishing carbon-based energy reserves and consequently contributes to green house gases in the atmosphere and climate change. Thus every potential cost and energy cutting measure for wastewater treatment should be explored. Microbial fuel cells (MFCs) could potentially yield such savings but, to achieve this, requires significant advances in our understanding in a few critical areas and in our designs of the overall systems. Here we review the research which might accelerate our progress towards sustainable wastewater treatment using MFCs: system control and modelling and the understanding of the ecology of the microbial communities that catalyse the generation of electricity.