A sewer system is an important infrastructure of every settlement. A sewer system is a set of construction facilities used for the quick removal of wastewater from the humans’ immediate environment and its transport to a wastewater treatment plant or direct discharge into an appropriate recipient. In order for the sewer system to perform its purpose properly, its proper maintenance is required. Maintenance of a sewer system is very demanding since the system is mostly underground which makes it difficult to be accessed and maintained. The maintenance of a sewer system can be preventive (regular) or corrective (reactive). The regular maintenance occurs at certain intervals, whereas the reactive maintenance occurs in the case of some unforeseen event. This paper presents the history of sewer systems, as well as basic and alternative types of sewer systems. Furthermore, challenges that arise during sewer system maintenance and difficulties that maintenance employees face in their work are presented in this paper, as well as the ways in which sewer systems are maintained.