This article provides a comprehensive review of decision support tools for water reuse (DST4WR), focusing on microbiological risk assessment (MRA), life cycle analysis (LCA), life cycle cost (LCC), and multi-criteria decision analysis (MCDA). A systematic review of 35 articles published between 2020 and 2024, plus one from 2019, was conducted. The studies were categorised based on the DST4WR applied, with each tool discussed individually. MRA tools assess public health risks in different case studies. LCA identifies key environmental indicators, and its integration with LCC facilitates comprehensive cost analysis. MCDA, applied in various case studies, uses criteria like environmental, social, economic, technical, public health, and functional aspects. Integrating DST4WR tools identifies synergies and trade-offs between criteria, aiding informed decision-making. Combining MRA, LCA/LCC, and MCDA is especially beneficial, as each tool provides a distinct perspective. Using these tools together offers a holistic view of water reuse management, ensuring that all relevant factors are balanced. This approach enhances decision-making and builds stakeholder confidence and acceptance by transparently addressing public health, environmental, economic, and social concerns.
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