Problems associated with sewage treatment and human wastes at high latitudes are briefly reviewed. In view of the fact that E. coli and other faecal bacteria can survive in the snow and the coastal waters of polar regions, several methods of how to deal with sewage outfalls in the Arctic and Antarctic are compared and discussed. Some consequences of raw sewage on the health of captive populations of a variety of Antarctic invertebrates and fish are described. Locomotion and respiration appear to be most affected. However, gaps, both in understanding the biological impact of human sewage on polar ecosystems and in finding optimal solutions for the disposal and treatment of the wastes generated by people who live in polar settlements, unfortunately still remain.