This paper presents a comprehensive approach with factors to select appropriate wastewater treatment systems in developing countries in general and Thailand in particular. Instead of focusing merely on the technical dimensions, the study integrates the social, economic, and environmental concerns to develop a set of criteria and indicators (C&I) useful for evaluating appropriate system alternatives. The paper identifies seven elements crucial for technical selection: reliability, simplicity, efficiency, land requirement, affordability, social acceptability, and sustainability. Variables are organized into three hierarchical elements, namely: principles, criteria, and indicators. The study utilizes a mail survey to obtain information from Thai experts—academicians, practitioners, and government officials—to evaluate the C&I list. Responses were received from 33 experts on two multi-criteria analysis inquiries—ranking and rating—to obtain evaluative judgments. Results show that reliability, affordability, and efficiency are among the most important elements, followed by sustainability and social acceptability. Land requirement and simplicity are low in priority with relatively inferior weighting. A number of criteria are then developed to match the contextual environment of each particular condition. A total of 14 criteria are identified which comprised 64 indicators. Unimportant criteria and indicators are discarded after careful consideration, since some of the indicators are local or site specific.

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