Rural domestic sewage treatment is crucial for improving rural living environment, controlling agricultural and rural pollution, and implementing the rural revitalization strategy. In this paper, we evaluated the achievements of rural domestic sewage treatment from the aspects of regulations and standards, treatment scale and technology, and environmental protection education, and analyzed the problems associated with treatment capacity, technology, standards, and operation and maintenance. Rural domestic sewage treatment should adapt to local conditions, focus on resource utilization, and be economical, convenient, and scientifically planned. Key tasks were proposed from the perspectives of treatment mode, technical process, resource utilization, and operating mechanism. The development path we proposed emphasizes systematic treatment and integration of all parties. Moreover, several countermeasures are suggested. Discharge standards should be formulated scientifically for rural domestic sewage as nitrogen and phosphorus in rural sewage needs to be reused for irrigation. Ecological and simple treatment of the rural domestic sewage should be promoted based on the economical and feasible principles. The market mechanism needs to be improved to promote the specialized trusteeship of rural sewage treatment.