It focuses on the identification of existing drivers of and barriers to the diffusion of energy-efficient technologies in India’s urban wastewater sector, uncovering how investments in resource- and lifecycle-oriented solutions could be enhanced. Key findings are that India’s urban wastewater sector is still largely in a situation of lock-in although first innovative initiatives that focus on more resource-footprint, lifecycle-oriented approaches exist in some niches. The diffusion of energy-efficient technologies is driven by pricing, mandatory regulations and standard-setting that are gradually being tightened. The privatization of building, operation and maintenance of treatment plants together with green procurement can be helpful if designed carefully. The main barriers against technology diffusion and a shift of the sector towards integrated approaches are a lack of cost recovery; vested interests in the status quo; a lack of operation and maintenance skills; and complicated processes, with many agencies and bureaucratic layers involved. Land and water scarcity are found to be catalytic to a change in planning, depending on local conditions.