Video streaming is becoming one of the most important services deployed over telecommunication networks such as the Internet and triple-play operators’ networks. This service differs from the rest in being loss sensitive and highly delay sensitive and requiring a considerable amount of bandwidth in order to offer a smooth transmission of packets through the network. While upgrading network elements with quality of service and multicast transmission capabilities becomes prohibitive for most network operators, peer-to-peer (P2P) architectures appear to be smart and efficient solutions to the previous issues. Many different P2P systems have been proposed and deployed to offer reliable video streaming services. These approaches address issues such as multicast transmission, quality of service enablement, mobility robustness, and video distribution according to network and user device capabilities. This chapter gives an overview of the different issues related to performance and reliability in multicast streaming over wireless networks and presents several alternatives facing them, including amendments to the already existing multicast mechanism of data distribution, video scalability and how peer-to-peer networking can provide a cost-effective solution to such problems.