Combined sewer overflows are major sources of water pollution problems, but even discharges of stormwater alone can seriously affect water quality. Current approaches involve control of overflows, treatment, and combinations of the two. Control may involve maximizing treatment with existing facilities, control of infiltration and extraneous inflows, surface sanitation and management, as well as flow regulation and storage. A number of treatment methods have been evaluated including high rate screening and microstraining, ultra high rate filtration, dissolved air flotation, physical/chemical treatment, and modified biological processes. A swirl flow regulator/solids separator of annular shape construction with no moving parts has been highly developed. High rate disinfection methods including new disinfectants have been applied. Promising approaches involve integrated use of controls and treatment.