Many developing countries face unique water treatment challenges and barriers because these communities do not have a well established socio-economic, educational, and technological infrastructure, which is capable of supporting conventional water treatment solutions. It is not uncommon for many proposed and implemented water treatment solutions to fail in the developing countries, especially in small, impoverished and rural communities. This chapter examines underlying factors that contribute to water treatment challenges and barriers in developing world communities and proposes a systems approach for developing a sustainable water treatment solution in small, rural, and impoverished communities. Five different categories of challenges and barriers to water treatment solutions in developing countries are identified and examined: (1) economics driven factors; (2) knowledge based factors; (3) socio-cultural implications; (4) adequacy of supporting infrastructure; and (5) environmental specifics. A systems approach, which stems from the need to resolve these challenges, is elucidated in an attempt to minimize the failure rate of implementing inadequate water treatment solutions in small, rural, and impoverished communities of the developing world.