Biofouling is one of the biggest impediments to the production of clean and safe water by membrane filtration. As contaminated water is filtered through the membrane, organic matter and microorganisms accumulate on the surface to form a biofilm which obstructs the water flow. A range of strategies have been developed to tackle this issue. Microorganisms and their nutrients can be removed from the feed water by different pretreatment methods to limit colonization and proliferation of microorganisms on the membrane. Furthermore, the membrane surface can be modified to achieve anti-adhesive, biocidal, or quorum quenching properties. These fouling prevention strategies can only delay the development of a biofilm, and the membranes must eventually be cleaned. Physical cleaning methods include air bubbles or ultrasound, but the most commonly used methods use chemical cleaning by applying biocides, acids, caustics, chelators, and surfactants. Chemical cleaning agents come with environmental and economic drawbacks, and biological cleaning solutions are therefore under development. These solutions include treatment with bacteriophages, quorum sensing inhibitors, and matrix-degrading enzymes. Despite extensive research on combatting biofouling, there is still no anti-fouling panacea. However, the additive effect of feedwater pretreatment, anti-adhesive membrane surfaces and the use of gentle biological membrane cleaning methods is bringing the industry closer to long-lasting mitigation of biofouling.