The Millcreek Township Sewer Authority was incorporated in 1956 under the Commonwealth of Pennsylvania, Pennsylvania Municipal Authorities Act of 1945. The Authority was formed to plan, finance, and construct sanitary sewers in Millcreek Township. The Sewer Authority has administered expansion of the original sewer system by land developers and has also constructed Authority sewer projects.

The sewer system provides for collection and transmission of sewage, with treatment at the City Waste Treatment Plant. Sewage flows from Summit and Fairview Townships are carried through the Millcreek system in accordance with agreements between the Townships.

The Millcreek Township Supervisors operate and maintain the sewer system under a lease agreement with the Sewer Authority. Semi-annual debt service payments are made by the Supervisors from sewer fees paid by the system's users. The Township employs fifteen people to operate and maintain the system. The sewer system contains approximately 376 miles of sewers and 38 pumping stations. The sewers range in size from 6-inch to 54-inch in diameter.

The Millcreek Township Supervisors also pay the Authority an annual amount equal to 1% of the valuation of the sewer system under a Sewer System Management Agreement. The monies are used for costs related to repairs and improvements to the sewer system. The amount paid in 2008 was $642,765. The amount to be paid to the Authority in 2009 is $655,891.

The Sewer Authority office staff consists of 9 full time and 1 part time personnel. This same staff also administers the Millcreek Township Water Authority and shares costs with the Water Authority. The Township sewer and water crew of 15 men and equipment operate the sewer and water systems.

The Millcreek Township Sewer Authority meetings are held monthly on the third Thursday of each month at the Authority office. Meetings start at 4:30 PM.