Abstract: Acid mine drainage (AMD) causes environmental pollution that affects many countries having historic or current mining industries. Preventing the formation or the migration of AMD from its source is generally considered to be the preferable option, although this is not feasible in many locations, and in such cases, it is necessary to collect, treat, and discharge mine water. There are various options available for remediating AMD, which may be divided into those that use either chemical or biological mechanisms to neutralise AMD and remove metals from solution. Both abiotic and biological systems include those that are classed as “active” (i.e., require continuous inputs of resources to sustain the process) or “passive” (i.e., require relatively little resource input once in operation). This review describes the current abiotic and bioremediative strategies that are currently used to mitigate AMD and compares the strengths and weaknesses of each. New and emerging technologies are also described. In addition, the factors that currently influence the selection of a remediation system, and how these criteria may change in the future, are discussed.