Lebanon is one of the richest countries in water resources in the Middle East. Despite its small geographical area, it faces escalating environmental challenges, including air pollution, water pollution, soil degradation, and poor waste management, that compromise natural resources, biodiversity, and public health. This review compiles and analyzes scientific literature and official reports on Lebanese river pollution from 1994 to 2024. It presents the status of river water quality, identifies major pollution sources and types, including untreated sewage, industrial discharges, and agricultural runoff, and highlights the use of bioindicators, alongside governmental and non-governmental mitigation efforts. Findings indicate widespread contamination across most Lebanese rivers due to the presence of pathogens, potentially toxic elements, and organic pollutants. Water quality degradation has often impaired access to safe water for drinking, irrigation, and industrial use. Although research and monitoring efforts have increased over the past decade, the implementation of control measures remains insufficient. Key challenges include fragmented environmental governance, lack of long-term monitoring programs, and limited public awareness. Addressing these issues requires integrated water resource management, stricter enforcement of environmental regulations, promotion of sustainable agricultural and industrial practices, and expansion of research on emerging contaminants. The evidence presented in this paper highlights the urgent need for science-informed policies and coordinated multi-sectoral actions to mitigate water pollution, restore riverine ecosystems, and safeguard both environmental.