Irrigated agriculture will play a dominant role in satisfying the increasing needs for rapidly universal population growth. Using treated wastewater effluent is in a promising resource to bridge the gap between the increasing supply and scarcity of available water resources. However, treated effluent has been successfully applied in many countries; but on the other hand, it should be subject to many major concerns which eventually have adverse impacts on health, crops and soil. Pollution control strategies should be integrated to mitigate the negative hygienic limitations and optimize crop production to achieve the sustainable agriculture and food security under water scarcity.