This paper presents a comparison between three simple sewage treatment lines involving natural processes: (a) upflow anaerobic sludge blanket (UASB) reactor–three maturation ponds in series–coarse rock filter; (b) UASB reactor–horizontal subsurface-flow constructed wetland; and (c) vertical-flow constructed wetlands treating raw sewage (first stage of the French system). The evaluation was based on several years of practical experience with three small full-scale plants receiving the same influent wastewater (population equivalents of 220, 60 and 100 inhabitants) in the city of Belo Horizonte, Brazil. The comparison included interpretation of concentrations and removal efficiencies based on monitoring data (organic matter, solids, nitrogen, phosphorus, coliforms and helminth eggs), together with an evaluation of practical aspects, such as land and volume requirements, sludge production and handling, plant management, clogging and others. Based on an integrated evaluation of all aspects involved, it is worth emphasizing that each system has its own specificities, and no generalization can be made on the best option. The overall conclusion is that the three lines are suitable for sewage treatment in small communities in warm-climate regions.