With the rapid development of urbanization and the transportation, cities are increasingly vulnerable to a variety of public health emergencies. Due to the limit of current knowledge about emerging pathogenic microorganisms, it is challenging to implement timely, accurate, and effective control strategies to prevent the outbreak of infectious diseases in their early stages. To enhance urban resilience and improve the capacity to deal with public health emergencies, this study reviews the literature to summarize the principles and applications of a novel environmental monitoring method— wastewater-based epidemiology (WBE), focusing on the research progress of WBE in the prevention and control of major infectious disease outbreaks. This study provides a detailed analysis of the current situation of public health emergency early warning and monitoring systems as well as urban drainage systems in China. Furthermore, it proposes to establish a public health surveillance system based on WBE technology to promote the urban resilience. It also verifies the feasibility of this surveillance system and provide suggestions for the future development. Firstly, the structure and arrangement of underground drainage pipe network system in typical communities in domestic cities and towns are investigated at a graded level to analyze the characteristics of the division of urban community units in China and to obtain the spatial distribution pattern of the laying of the municipal pipe network system in China’s communities. Secondly, because the phenomenon of infiltration into the drainage network is more serious in China, which may dilute the concentration of viral RNA in sewage and affect the accuracy of the WBE monitoring results, consideration can be given to setting up additional sewage sampling points in communities with high population mobility or dense populations that are at risk of potential epidemic transmission. Thirdly, given the potential uncertainty of WBE technology, it is necessary to further delineate the suspected community based on the diagnosis and treatment data from community hospitals, first- and second-tier hospitals, and hospitals for infectious diseases in the area after the initial identification of the suspected risk area, and to send investigators to conduct epidemiological traceability investigations in the suspected risk area. The WBE technology can provide objective information on the health or infection status of the population for the early warning, prediction and surveillance system of public health emergencies through the detection of viruses and their markers in wastewater, which is of potential application value and possibility. Nevertheless, due to the limitations of the existing drainage system and sewage detection technology, there has not been any practical application of WBE-based public health event monitoring system in China. Based on the relevant research results at home and abroad and the future development of China’s drainage system, this study introduces the principle and application of WBE technology in detail, and based on the collection and processing capacity of China’s drainage system, makes suggestions on the specific implementation program of WBE technology and the construction of the urban public health emergency monitoring system in the hope of providing theoretical support to enhance the city’s resistance to the impacts of sudden and major public health events.