Water bodies' quality objectives are defined in accordance with the Urban Wastewater Treatment Directive 91/271/EEC and the Water Framework Directive 2000/60/EC. For regulation and control of small-sized waste-water treatment plants (WWTPs), responsibility is delegated in Italy to Regional Authorities that fix specific regulations (Water Protection Plan WPP included in the River Basin Management Plan RBMP) in collaboration with the District Authorities. Small (<2,000 population equivalent – PE) and medium sized (2,000–10,000 PE) WWTPs in the Veneto Region (North Italy) represent about 10% of the total organic load (Imhoff systems included). This also comprises some industrial discharges. Due to the urban sprawl, plants are spread over the regional territory. In the Veneto Region, data from the official census reveals there are n. 248 plants under 2,000 PE and 135 plants in 2,000–10,000 range while the total number of authorized plants is 488 for a total potentiality of 9,141,572 PE. Data from institutional controls performed by the Veneto Regional Environmental Agency (ARPAV) on WWTPs has been recovered for all the WWTPs with up to 10,000 PE in the provinces of Venice, Treviso and Vicenza (for a total of 306,118 PE and for a total of 164 plants) in the period 2008–2015 and elaborated to assess critical parameters and plants. The general situation, critical issues and case studies have been presented and discussed. Organic load, nutrients and Escherichia coli are the most critical parameters considering the regional WPP.