Runoff from open lot livestock systems (beef and dairy) defined as Concentrated Animal Feeding Operations (CAFO) must be controlled by systems designed and managed to prevent the release of manure-contaminated runoff for storms equal to or less than a 25-yr, 24-h design storm. This performance standard has been attained for open lot systems with some combination of clean water diversion, settling basins, runoff collection ponds, and irrigation systems (baseline system). An alternative approach is to rely on overland flow and infiltration into cropland with perennial forage or grasses for treatment of open lot runoff. Such vegetative systems have been researched since the late 1960s. This article reviews the research literature on vegetative treatment systems (VTS) for managing open lot runoff summarizing available science on system performance, design, and management. Based upon this review of the literature, the following conclusions are drawn about the application of VTS to manage runoff from open lot livestock production systems: (1) Substantial research (approximately 40 identified field trials and plot studies) provides a basis for understanding the performance of VTS. These performance results suggest that a vegetative system consisting of a settling basin and VTA or Vegetative Infiltration Basin (VIB) has the potential to achieve functional equivalency to conventional technologies. (2) The existing research targeting VTS is confined to non-CAFO applications, likely due to past regulatory limits. Unique challenges exist in adapting these results and recommendations to CAFO applications. (3) The pollutant reduction resulting from a VTS is based upon two primary mechanisms: 1) sedimentation, typically occurring within the first few meters of a VTS, and 2) infiltration of runoff into the soil profile. Systems relying primarily on sedimentation only are unlikely to perform equal to or better than baseline technologies. System design based upon sedimentation and infiltration is necessary to achieve a required performance level for CAFO application. (4) Critical design factors specific to attaining high levels of pollutant reduction within a VTS include pre-treatment, sheet flow, discharge control, siting, and sizing. Critical management factors include maintenance of a dense vegetation stand and sheet flow of runoff across VTA as well as minimization of nutrient accumulation.