Aquatic macrophyte-based treatment systems (AMTS) provide an eco-friendly, sustainable, and cost-effective solution for treating domestic and industrial wastewater and for restoring polluted water bodies. In these systems, macrophytes either float directly on the water surface or grow on floating frames, with their roots suspended in the water to absorb nutrients and heavy metals. The roots release oxygen, maintaining aerobic conditions in the rhizosphere and providing surface area for microorganisms that break down contaminants. Additionally, aquatic macrophytes act as bioindicators of pollution, exhibiting stress responses such as stunted growth, leaf discoloration, or reduced biomass when exposed to toxins, heavy metals, or excess nutrients, thereby helping to monitor water quality and eutrophication. The effectiveness of AMTS depends on factors such as water depth, vegetation coverage, pollutant concentration, residence time, and plant species used. Regular harvesting is essential to prevent the release of accumulated pollutants back into the water. Further research is needed to optimize the system's performance and promote its large-scale application.