On-site individual wastewater treatment systems can provide a financially attractive alternative to a sewer connection in locations far from the existing sewer network. These systems are, however, relatively new, and therefore, shortcomings in the design or operation problems still occur frequently. A previously performed survey revealed that most system owners neither carry out routine operation and maintenance tasks nor have a maintenance agreement with the manufacturer. This suggests that in reality, systems are often improperly managed and do not provide the level of treatment necessary to adequately protect surface and ground waters. To substantiate this statement, the field performance of 23 currently installed individual wastewater treatment systems in Belgium has been assessed.The results of this study confirm that many installed individual systems do not perform well: 52% of them do not meet all the legal effluent standards (BOD, COD, SS). Activated sludge systems prove to be less efficient than biofilm-based systems and extensive systems perform better than compact systems. Maintenance problems and to a lesser extent improperly designed systems are indeed the main cause of unsatisfactory results through, e.g., wash out.