Promoting the resource utilization of rural domestic sewage is an important measure to improve the living environment in rural areas in China. In recent years, there has been an increasing focus on addressing the actual conditions in rural domestic sewage treatment. The treatment approach has shifted from sewage treatment to resource utilization, aiming for a simple, efficient, and sustainable treatment model. However, the emergence of new contaminants in rural domestic sewage poses risks and challenges to the process of resource utilization. Against this background, this study summarizes three current modes of resource utilization in rural domestic sewage treatment in China: Effluent irrigation, economic crop cultivation, and gray-black separation. The planting modes and the selection of wetland economic crops in the artificial wetland technology are highlighted. Various types of gray-black separation techniques are proposed based on variations in living environments and absorption capacities in rural areas. Furthermore, the presence of emerging contaminants such as microplastics and antibiotics in rural domestic sewage is considered. The study discusses and analyzes the development direction of resource utilization in light of these contaminants.