Clogging in vertical flow (VF) wetlands is an important process influencing water purification processes. The main contributing factors are the growth of microorganisms within the filter media, the accumulation of suspended solids on top of the wetland, as well as within the filter media. Both processes lead to a decrease of the available pore space, hence changing the soil’s hydraulic properties. This will alter the water flow and cause malfunctioning of the system. This paper summarizes the state of the art of the prevailing physical, biological and chemical processes influencing clogging in VF wetlands. Different design and operational parameters are discussed to give a better understanding on their influence to prevent malfunctioning. Based on a literature review, a detailed overview on experimental as well as modelling studies carried out is presented. The main conclusions are that on the one hand, important insights on clogging processes in VF wetlands have been gained but, on the other hand, design parameters such as intermittent loading operation and the grain size of the filter media are not well represented in those studies. Clogging models use different conceptual approaches ranging from black box models to process based models.