Constructed wetlands (CW) are a treatment option for agricultural wastewater. Their ability to adequately function in cold climates continues to be evaluated as they are biologically active systems that depend on microbial and plant activity. In order to assess their performance and to highlight regional specific design considerations, a review of CWs in Eastern Canada and the Northeastern USA was conducted. Here, we synthesize performance data from 21 studies, in which 25 full-scale wetlands were assessed. Where possible, data were separated seasonally to evaluate the climatic effects on treatment performance. The wastewater parameters considered were five-day biochemical oxygen demand (BOD5), total suspended solids (TSS), E. coli, fecal coliforms, total Kjeldahl nitrogen (TKN), ammonia/ammonium (NH3/NH4+-N), nitrate-nitrogen (NO3−-N), and total phosphorus (TP). Average concentration reductions were: BOD5 81%, TSS 83%, TKN 75%, NH4+-N 76%, NO3−-N 42%, and TP 64%. Average log reductions for E. coli and fecal coliforms were 1.63 and 1.93, respectively. Average first order areal rate constants (ka, m·y−1) were: BOD5 6.0 m·y−1, TSS 7.7 m·y−1, E. coli 7.0 m·y−1, fecal coliforms 9.7 m·y−1, TKN 3.1 m·y−1, NH4+-N 3.3 m·y−1, NO3−-N 2.5 m·y−1, and TP 2.9 m·y−1. In general, CWs effectively treated a variety of agricultural wastewaters, regardless of season.