Constructed wetland microcosms (CWMs) are artificially designed ecosystem which utilizes both complex and ordinary interactions between supporting media, macrophytes, and microorganisms to treat almost all types of wastewater. CWMs are considered as green and sustainable techniques which require lower energy input, less operational and maintenance cost and provide critical ecological benefits such as wildlife habitat, aquaculture, groundwater recharge, flood control, recreational uses, and add aesthetic value. They are good alternatives to conventional treatment systems particularly for smaller communities as well as distant and decentralized locations. The pH, dissolved oxygen (DO), and temperature are the key controlling factors while several other parameters such as hydraulic loading rates (HLR), hydraulic retention time (HRT), diversity of macrophytes, supporting media, and water depth are critical to achieving better performance. From the literature survey, it is evaluated that the removal performance of CWMs can be improved significantly through recirculation of effluent and artificial aeration (intermittent). This review paper presents an assessment of CWMs as a sustainable option for treatment of wastewater nutrients, organics, and heavy metals from domestic wastewater. Initially, a concise note on the CWMs and their components are presented, followed by a description of treatment mechanisms, major constituents involved in the treatment process, and overall efficiency. Finally, the effects of ecological factors and challenges for their long-term operations are highlighted.