Nitrate contamination in surface and ground waters is one of this century's major engineering challenges due to negative environmental impacts and the risk to human health in drinking water. Electrochemical reduction is a promising water treatment technology to manage nitrate in drinking water. This critical review describes the fundamental principles necessary to understand electrochemical reduction technologies and how to apply them. The focus is on electrochemical nitrate reduction mechanisms and pathways that form undesirable products (nitrite, ammonium) or the more desirable product (dinitrogen). Factors influencing the conversion rates and selectivity of electrochemical nitrate reduction, such as electrode material and operating parameters, are also described. Finally, the applicability for treating drinking water matrices using electrochemical processes is analyzed, including existing implementation of commercial treatment systems. Overall, this critical review contributes to the understanding of the potential applications and constraints of electrochemical reduction to manage nitrate in drinking waters and highlights directions for future research required for implementation.