Combined sewer overflows and stormwater discharges represent an important source of contamination to the environment. However, the harsh environment inside sewers and particular hydraulic conditions during rain events reduce the reliability of traditional flow measurement probes. In the following, we present and evaluate an in situ system for the monitoring of water flow in sewers based on video images. This paper focuses on the measurement of the water level based on image-processing techniques. The developed image-based water level algorithms identify the wall/water interface from sewer images and measure its position with respect to real world coordinates. A web-based user interface and a 3-tier system architecture enable the remote configuration of the cameras and the image-processing algorithms. Images acquired and processed by our system were found to reliably measure water levels and thereby to provide crucial information leading to better understand particular hydraulic behaviors. In terms of robustness and accuracy, the water level algorithm provided equal or better results compared to traditional water level probes in three different in situ configurations.