Water scarcity and its pollution has become a concern in recent times. The disposal of nutrient-rich (nitrogen and phosphorous) wastewater is also one of the main cause of water pollution through eutrophication, reduced dissolved oxygen that poses threat to aquatic ecosystems. As a result, nutrient removal has become a mandate apart from the removal of organics. However, the removal of nutrients from sewage is a challenging task. Conversely, conventional biological treatment processes provide little relief in nutrient removal. The treated effluents from conventional biological processes do not achieve the stringent nutrient removal disposal standard limits and become primary cause of pollution in the receiving water bodies. This has stressed upon the need for eco-friendly, low-energy and cost-efficient nutrient removal treatment technologies. Various biological treatment combinations or variants are in use for the efficient removal of nutrients. The biological processes in itself or in combination with chemical processes are preferred over technologies based solely on physico-chemical processes for its treatment performance at lower cost. This review summarizes the existing treatment processes and their possible up-gradation with the aim to accomplish the marked effluent standards for the nutrients. The concept of conventional systems and advanced systems for nutrients (nitrogen and phosphorous) removal which are already developed or under development are deeply discussed. Further, the challenges of each treatment systems are abridged. Finally, the possible suggestions for the modification/retrofitting of existing treatment systems for achieving stringent disposal standards are pointed out.