Humanity faces serious problems related to water supply, which will be aggravated by population growth. The water used in human activities must be treated to make it available again without posing risks to human health and the environment. In this context, Wastewater Treatment Plants (WWTPs) have gained importance. The treatment process in WWTPs is complex, consisting of several stages, which consume considerable amounts of resources, mainly electrical energy. Minimizing such energy consumption while satisfying quality and environmental requirements is essential, but it is a challenging task due to the complexity of the processes carried out in WWTPs. One form of evaluating the performance of WWTPs is through the well-known Key Performance Indicators (KPIs). The KPIs are numerical indicators of process performance, being a simple and common way to assess the efficiency and eco-efficiency of a process. By applying KPIs to WWTPs, techniques for monitoring, predicting, controlling, and optimizing the efficiency and eco-efficiency of WWTPs can be created or improved. However, the use of computational methodologies that use KPIs (KPIs-based methodologies) is still limited. This paper provides a literature review of the current state-of-the-art of KPI-based methodologies to monitor, control and optimize energy efficiency and eco-efficiency in WWTPs. In this paper, studies presented on 21 papers are identified, assessed and synthesized, 12 being related to monitoring and predicting problems, and 9 related to control and optimization problems. Future research directions relating to unresolved problems are also identified and discussed.