This paper discusses two prominent perspectives in the debate on risk reduction in wastewater irrigation; reliance on conventional wastewater treatment and the multiple-barrier approach. The treatment perspective is based on water-quality standards for wastewater irrigation with treatment considered the ultimate risk reductionmeasure. The somewhat broader multiple-barrier perspective supports the use of a combination of pre-farm, on-farm and postfarm barriers, including, where possible, wastewater treatment, to meet required health targets. The discussion in this paper shows that each perspective has strengths and mitations. Rather than being opposing philosophies, they both support health risk reduction but in different ways depending on the level of the country in the sanitation ladder. Since each perspective has limitations, the recommendation is to capitalize on their strengths and explore synergies to optimize their applications for optimum risk reduction.