Desalination of groundwater and brackish water reverse osmosis is becoming more common worldwide as a means of supplementing and diversifying fresh water supply. However, a key impediment to extensive reverse osmosis desalination adoption, particularly at inland sites, is the lack of economic and ecologically viable reject management alternatives. The reverse osmosis concentrate can harm the ecosystem by causing pH fluctuations, eutrophication, and the proliferation of hazardous metals that can cause various issues in the aquatic ecosystem and subsurface habitat degradation. Several alternative technologies have been explored to enhance reverse osmosis water recovery, limit the reject volume that must be disposed, and eliminate contaminants prior to beneficial uses or discharge. This review examines reject management options and technologies, including disposal, treatment, and beneficial usage. A comparative study reviewing all the plausible methodologies practically employed to economically and feasibly treat varied types of reverse osmosis concentrate is currently unavailable. This review also examines the suitability of the different treatment technologies for different types of reverse osmosis concentrate. The review also identifies important hurdles to a larger usage of desalination procedures, especially for inland applications, by critically reviewing reject management systems, treatment technologies, and beneficial uses. At last, conclusion and future perspectives are provided for researchers working in this field.