Although decentralized wastewater and distributed water reuse professionals represent a key part of environmental public health and environmental engineering, an understanding of workforce challenges has remained elusive. Here we begin to address the critical need of understanding education, training, and outreach needs for decentralized wastewater and distributed water reuse. We specifically engaged professionals working in health departments and other government agencies, industry, academia, and nongovernmental organizations. We examined workforce characteristics related to education, training, and outreach. We found that 37% of decentralized wastewater and distributed water reuse professionals plan to retire within 5 years, approximately 25% of these professionals do not hold any type of certification, and education and training are insufficient to meet current workforce demands. We further report 10 problem statements associated with timely education, training, and outreach needs, which represent important opportunities for improving the practice of decentralized wastewater and distributed water reuse. Strategic education, training, and outreach activities are necessary to ensure workforce preparedness, to promote education with owners of onsite technologies, and to expand advanced training and translational research programs in decentralized wastewater and distributed water reuse. Our findings can specifically support decision making aimed at sustaining and advancing the decentralized wastewater and distributed water reuse workforce.