Seasonal or permanent water scarcity in off-grid communities can be alleviated by recycling water in decentralized wastewater treatment systems. Nature-based solutions, such as constructed wetlands (CWs), have become popular solutions for sanitation in remote locations. Although typical CWs can efficiently remove solids and organics to meet water reuse standards, polishing remains necessary for other parameters, such as pathogens, nutrients, and recalcitrant pollutants. Different CW designs and CWs coupled with electrochemical technologies have been proposed to improve treatment efficiency. Electrochemical systems (ECs) have been either implemented within the CW bed (ECin-CW) or as a stage in a sequential treatment (CW + EC). A large body of literature has focused on ECin-CW, and multiple scaled-up systems have recently been successfully implemented, primarily to remove recalcitrant organics. Conversely, only a few reports have explored the opportunity to polish CW effluents in a downstream electrochemical module for the electro-oxidation of micropollutants or electro-disinfection of pathogens to meet more stringent water reuse standards. This paper aims to critically review the opportunities, challenges, and future research directions of the different couplings of CW with EC as a decentralized technology for water treatment and recovery.