For decades much of Santiago's wastewater reached the Mapocho. A 28.5-kilometer underground interceptor now carries sewage to the La Farfana and Mapocho-Trebal treatment plants, and a local foundation told the outlet Pauta in 2024 that the river no longer receives wastewater but still collects debris from points across the city.
Some pressures remain. A 2024 study in Science of the Total Environment detected 73 contaminants of emerging concern in wastewater samples, found none upstream of the treatment plants, and attributed those found downstream mainly to effluent discharge. A 2022 international study of 258 rivers placed the Mapocho among the more pharmaceutically contaminated, as reported by El Mostrador. In 2024, groups at the Maipo estuary also described heavy rains carrying large amounts of plastic and construction waste downriver from Santiago.