The availability of clean drinking water continues to be a major problem in most rural and resource-constrained areas because of the growing water pollution by microbial, physical and chemical contaminants. Traditional water treatment systems prove to be very costly, power-intensive and inappropriate when used in decentralised systems. This review examines the possibility of using Moringa oleifera Lam. seeds as a natural, low-cost and environmentally friendly alternative for purifying water, especially in rural areas. Biochemical composition, agronomic flexibility and botanical traits of the seeds of M. oleifera are investigated in terms of their capacity to treat water. The availability of water-soluble cationic proteins facilitates successful coagulation and flocculation of suspended particles and microorganisms through neutralisation of negatively charged suspended particles and microorganisms, leading to high turbidity reduction and reduction of microbial load. M. oleifera seeds have been reported to have up to 90–99 % turbidity removal efficiency, over 90 % removal of total coliforms and Escherichia coli in highly contaminated waters and moderate adsorption efficiency for selected heavy metals like lead (Pb), cadmium (Cd) and copper (Cu), showing that M. oleifera is a sustainable natural coagulant for decentralized water treatment systems. Other processes, such as antimicrobial effects and adsorption of certain heavy metals, are explained. The effect of seed processing techniques, dosage control, water quality variables and conditions of treatment on purification efficiency is critically reviewed. Laboratory-based methods and traditional and indigenous practices are compared in terms of feasibility and performance consistency. Such limitations include fluctuations in seed quality, partial elimination of pathogens, residual organic matter that has remained and storage stability. Other issues include toxicology safety, socioeconomic benefits and environmental sustainability. Altogether, M. oleifera seeds hold the potential to be a low-cost solution to the current quality of drinking water among rural populations, if they are implemented within the framework of optimized and combined treatment systems.