Abstract The malfunction of sewerage systems and rain water drainage networks is perceived as a very crucial problem by authorities in Côte d'Ivoire, both from an environmental point of view as well as the associated maintenance costs. This paper discusses the state of the sewerage systems, the malfunctions and environmental concepts used to categorize the problems, and the methodological options to prioritize the various management solutions. This review also presents the selection of decision support tools for sewerage asset management. The tools were classified according to their capability and functionality. The working principle of each of these tools was described and the corresponding data requirements were determined. Moreover, the paper discussed the problems associated with the use of existing tools and presents a perspective on future research needs in the field of decision support tools. This paper represents a comprehensive review of the sewage systems management challenges and can serve as a reference document for other developing countries in Sub-Saharan Africa.