Remediation of contaminated groundwater in karst arguably presents the greatest challenge when compared to all other porous media and types of aquifers. The nature of triple porosity in karst (rock matrix, fractures, and conduits) makes it difficult to characterize the nature and delineate the extent of groundwater contamination, which is the main prerequisite for a successful remediation. Moreover, even if such characterization is reasonably accurate, it may be technically impracticable to restore a karst aquifer to its pre-contamination state within a reasonable timeframe. Unfortunately, in many cases the involved regulatory agencies, as well as the consultants, approach groundwater remediation in karst using methods and technologies that may be applicable to other types of aquifers but often fail in karst because of the lack of understanding of the many intricacies of karst hydrogeology and contaminant fate and transport in karst. At the same time, various stakeholders and the regulatory agencies by extension, are not ready to accept that groundwater remediation in karst may in some cases be technically impracticable. This leads to wasted efforts before any realistic risk analyses are performed and before designing a groundwater remediation system that would meet sustainable remediation’s triple bottom line: social, economic, and environmental factors.