Decreasing per capita water consumption in several OECD countries has led to a notable flow reduction into sewer systems. However, sewers still transport similar quantities of solids and pollutants, leading to increased wastewater concentration and, potentially, excess solids deposition. The shift towards decentralised water schemes in cities and widely reported changes in rainfall patterns cast additional uncertainty on future wastewater quality and flows into sewers. Excess solids deposition in sewers can cause increased environmental pollution risks at Combined Sewer Overflows from solids resuspension and reduced sewer hydraulic capacities. This review analyses the magnitude of excess solids deposition due to changing wastewater composition and evaluates current approaches to modelling sewer solids. Gaps in commonly used modelling approaches for deposited bed processes, specifically in bed consolidation and bed particle cohesion processes, and gross solids transport were identified and addressed to enable better solids risk prediction and management.