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The treatment and reuse of industrial wastewater is an important key practice for a sustainable water resources management. Waste-water reuse is a goal to be achieved to tackle and manage the scarcity of water resources caused also by the climate changes in particular in the Mediterranean area. This study aims to identify a set of suitable tools needed to assess the potential reuse of treated wastewater from medical devices (MDs) and pharmaceutical manufacturers taking into account ecogenotoxicological and microbiological parameters. The microbiological parameters investigated were Bacterial Total Count (BTC), E. coli, Enterococci, Staphylococcus spp., Pseudomonas spp. A set of ecotoxicological assays was selected for this study: the bacterium Vibrio fischeri, the alga P. subcapitata, the crustacean Daphnia magna, the fish Danio rerio and the plant Sorghum saccharatum. Seeds of Vicia faba were used for the assessment of the genotoxic effects of wastewater using the Micronucleus test (MN-test). The sampling was performed at three MDs manufacturers and were collected at the inlet and outlet of water treatment plants. The results show a significant decrease in treated wastewater samples of the microbiological parameters and the absence of E. coli. The ecotoxicological assays highlight a significant toxicity of the wastewater before the treatment, while a decrease has been recorded after the treatment for some samples. Genotoxic and sublethal effects were reported in some samples for Vicia faba's micronucleus frequencies and fish embryos respectively. Even though preliminary, this approach can be considered a useful tool in the context of the wastewater industrial reuse management and a possible support to the legislation.