Escherichia coli O157:H7 is a significant human pathogen which has mostly foodborne and waterborne modes of transmission. Although capable of infecting several hosts, the main source of this bacterium is cattle. In humans, it mainly causes hemorrhagic colitis, bloody diarrhea, and hemolytic uremic syndrome. This bacterial pathogen is fairly resistant to various stresses and can survive for significant periods of time in the environment outside of a host. Some of the factors impacting its survival include the indigenous microbial communities, its ability to attach to food contact surfaces and form biofilms, temperature, and dehydration. To address the public health concerns associated with this pathogen, several disinfection and sanitization procedures and technologies have been developed in recent years. Synergies between different procedures have been evaluated as well. This review addresses recent developments regarding the survival and disinfection of E. coli O157:H7.