Wastewater surveillance is a valuable tool for monitoring infectious disease dynamics. However, its integration into outbreak control strategies in congregate settings requires further exploration. As observed during the SARS-CoV-2 pandemic, these high-risk environments can facilitate large outbreaks, further exacerbated by residents’ heightened vulnerability. Congregate settings exhibit distinct epidemiological dynamics that influence wastewater surveillance. For instance, their semi-closed populations and reduced mobility can lower environmental noise in wastewater signals, but small population sizes also increase stochastic fluctuations, complicating the interpretation of disease trends. In this context, mathematical modeling helps translate wastewater signals into actionable insights for outbreak response. This work synthesizes key benefits and challenges in applying wastewater surveillance in congregate settings and identifies modeling approaches that have potential to improve outbreak detection, monitor transmission dynamics, and optimize infection control strategies. This provides a conceptual framework for expanding wastewater surveillance to strengthen infectious disease control in these high-risk populations.