Electrochemical disinfection-a method in which chemical oxidants are generated in situ via redox reactions on the surface of an electrode-has attracted increased attention in recent years as an alternative to traditional chemical dosing disinfection methods. Because electrochemical disinfection does not entail the transport and storage of hazardous materials and can be scaled across centralized and distributed treatment contexts, it shows promise for use both in resource limited settings and as a supplement for aging centralized systems. In this Critical Review, we explore the significance of treatment context, oxidant selection, and operating practice on electrochemical disinfection system performance. We analyze the impacts of water composition on oxidant demand and required disinfectant dose across drinking water, centralized wastewater, and distributed wastewater treatment contexts for both free chlorine- and hydroxyl-radical-based systems. Drivers of energy consumption during oxidant generation are identified, and the energetic performance of experimentally reported electrochemical disinfection systems are evaluated against optimal modeled performance. We also highlight promising applications and operational strategies for electrochemical disinfection and propose reporting standards for future work.