Horizontal wells play an often overlooked role in hydrogeology and aquifer remediation but can be an interesting option for many applications. This study reviews the constructional and hydraulic aspects that distinguish them from vertical wells. Flow patterns towards them are much more complicated than those for vertical wells, which makes their mathematical treatment more demanding. However, at some distance, the drawdown fields of both well types become practically identical, allowing simplified models to be used. Due to lower drawdowns, the yield of a horizontal well is usually higher than that of a vertical well, especially in thin aquifers of lower permeability, where they can replace several of the latter. The lower drawdown, which results in lower energy demand and slower ageing, and the centralized construction of horizontal wells can lead to lower operational costs, which can make them an economically feasible option.