Engineered nanomaterials (ENMs) are increasingly found in a wide range of products and processes, and consequently increasing loads are expected to reach wastewater treatment plants (WWTPs). To better assess the potential risk of ENMs to the environment via input through WWTP effluents, this review considers ENM detection methods, fate in WWTPs and potential effects on biota exposed to wastewater associated ENMs. Characterising ENMs in complex matrices presents many challenges, especially at low concentrations. Combining separation methods with techniques to assess particle size and chemical composition appears to be the most suitable approach for wastewater. In a range of studies, the majority of ENMs are removed from the aqueous phase by flocculation and sedimentation and remain in the sludge. However, ENM surface coating and the presence of organic matter and surfactants can alter removal. ENMs may affect biota via discharge of treated effluent to the aquatic environment or by application of sewage sludge to soil, although observed effects in laboratory studies only occurred at concentrations several orders of magnitude higher than the expected environmental levels. More realistic experimental designs with improved quantification of ENM properties under the selected test conditions are required to better understand the fate and effect of ENMs associated with WWTPs.