Vibrio infections remain a serious threat to public health. In the last decade, Vibrio disease outbreaks have created a painful awareness of the personal, economic, societal, and public health costs associated with the impact of contaminated water in the aquatic milieu. This study was therefore designed to assess the prevalence of Vibrio pathogens in the final effluents of wastewater treatment plants (WWTPs) in the Eastern Cape Province, as well as their abilities to survive the treatment processes of the activated sludge system either as free cells or as plankton-associated entities in relation to the physicochemical qualities of the effluents. Three wastewater treatment facilities were selected to represent typical urban, sub-urban and rural communities, and samples were collected monthly from August 2007 to July 2008 from the final effluent, discharge point, 500 meter upstream and downstream of the discharge points and analysed for physicochemical parameters, Vibrio pathogens prevalence and their antibiogram characteristics using both culture based and molecular techniques. Physicochemical parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), chemical oxygen demand (COD), nitrate, nitrite and orthophosphate levels. Unacceptably high levels of the assayed parameters were observed in many cases for COD (<10 - 1180 mg/l), nitrate (0.08 - 13.14 mg NO3- as N/l), nitrite (0.06 - 6.78 mg NO2- as N/l), orthophosphate (0.07-4.81 mg PO43- as P/l), DO (1.24 - 11.22 mg/l) and turbidity (2.04 -159.06 NTU). Temperature, COD and nitrite varied significantly with season (P < 0.05), while pH, EC, salinity, TDS, COD, and nitrate all varied significantly with sampling site (P < 0.01; P < 0.05). In the rural wastewater treatment facility, free-living Vibrio densities varied from 0 to 3.45 × 101 cfu ml-1, while the plankton-associated Vibrio densities vary with plankton sizes as follows: 180 μm (0 – 4.50 × 103 cfu ml-1); 60 μm (0 – 4.86 × 103 cfu ml-1); 20 μm (0 – 1.9 × 105 cfu ml-1). The seasonal variations in the Vibrio densities in the 180 and 60 μm plankton size samples were significant (P < 0.05), while the 20 μm plankton size and free-living vibrios densities were not. Molecular confirmation of the presumptive vibrios isolates revealed V. fluvialis (36.5 percent), as the predominant species, followed by V. vulnificus (34.6 percent), and V. parahaemolyticus (23.1 percent), and V. metschnikovii (5.8 percent) (detected using only API 20 NE), suggesting high incidence of pathogenic Vibrio species in the final effluent of the wastewater facility. Correlation analysis suggested that the concentration of Vibrio species correlated negatively with salinity and temperature (P < 0.001 and P < 0.002 respectively) as well as with pH and turbidity (P < 0.001), in the final effluent. Population density of total Vibrio ranged from 2.1 × 101 to 4.36 × 104 cfu ml-1 and from 2.80 ×101 to 1.80 × 105 cfu ml-1 for the sub-urban and urban communities treatment facilities respectively. Vibrio species associated with 180 μm, 60 μm, and 20 μm plankton sizes, were observed at densities of 0 - 1.36 × 103 cfu ml-1, 0 - 8.40 × 102 cfu ml-1 and 0 - 6.80 × 102 cfu ml-1 respectively at the sub-urban community‘s WWTP. In the urban community, counts of culturable vibrios ranged from 0 - 2.80 × 102 cfu ml-1 (180 μm); 0 - 6.60 × 102 cfu ml-1 (60 μm) and 0 -1.80 × 103 cfu ml-1 (20 μm). Abundance of free-living Vibrio species varied between 0 and the orders of 102 and 103 cfu ml-1 in the sub-urban and urban communities WWTPs respectively. Molecular confirmation of the presumptive vibrios isolates revealed the presence of V. fluvialis (41.38 percent), V. vulnificus (34.48 percent), and V. parahaemolyticus (24.14 percent) in the sub-urban community effluents. In the urban community V. fluvialis (40 percent), V. vulnificus (36 percent), and V. parahaemolyticus (24 percent) were detected. There was no significant correlation between Vibrio abundance and season, either as free-living or plankton-associated entities, while Vibrio species abundance correlated positively with temperature (r = 0.565; P < 0.01), salinity and dissolved oxygen (P < 0.05). Turbidity and pH showed significant seasonal variation (P < 0.05) in both locations. The Vibrio strains showed the typical multi-antibiotic-resistance of an SXT element. They were resistant to sulfamethoxazole (Sul), trimethoprim (Tmp), cotrimoxazole (Cot), chloramphenicol (Chl) and streptomycin (Str), as well as other antibiotics such as ampicillin (Amp), penicillin (Pen), erythromycin (Ery), tetracycline (Tet), nalidixic acid (Nal), and gentamicin (Gen). The antibiotic resistance genes detected includes dfr18 and dfrA1 for trimethoprim; tetA, strB, floR, sul2 blaP1, for tetracycline, streptomycin, chloramphenicol, sulfamethoxazole and β-lactams respectively. A number of these genes were only recently described from clinical isolates, demonstrating genetic exchange between clinical and environmental Vibrio species. This study revealed that there was an adverse impact on the physicochemical characteristics of the receiving watershed as a result of the discharge of inadequately treated effluents from the wastewater treatment facilities. The occurrence of Vibrio species as plankton-associated entities confirms the role of plankton as potential reservoir for this pathogen. Also the treated final effluents are reservoirs of various antibiotics resistance genes. This could pose significant health and environmental risk to the biotic component of the environment including communities that rely on the receiving water for domestic purposes and may also affect the health status of the aquatic milieu in the receiving water. There is need for consistent monitoring programme by appropriate regulatory agencies to ensure compliance of the wastewater treatment facilities to regulatory effluent quality standards.