Living walls and green roofs offer numerous benefits to densely populated urban areas such as cooling, air filtering and improved aesthetics. However, plants in these two systems are high water consumers making such systems particularly unsuitable for water-scarce arid environments most at need of passive cooling and urban greening. Integrated greywater treatment in these structures provides a possible solution, providing plants not only with water but other required nutrients and organics. However, greywater treatment by living wall and green roof systems is still lacking. This review summarizes the few studies exploring this new integrated technology and provides an in-depth analysis of existing literature on vegetated building structures and greywater treatment to reveal benefits and potential pitfalls of this technology. Appropriate selection of plants and media are essential to successful system design and must meet competing demands compared to those used in existing vegetated building structures for cooling/greening and constructed wetlands for greywater treatment. A variety of operational and user-interaction issues are also explored and will be key areas of future research to enable full-scale implementation. Integrated greywater treatment using green building vegetated structures appears a promising method for dual purpose water recycling and urban cooling, and various future research needs are emphasized to realize this.