Progress in urban water supply and sanitation has been slow over the past few decades. The sector suffers from issues of equity and efficiency. Today, more than 780 million people are still without access to improved sources of water, and 2.5 billion lack improved sanitation. Those average figures mask huge disparities between the rich and the poor, the poor consistently have less access to reliable services than the non-poor. Even those who do have networked service often suffer from irregular service and poorly maintained infrastructure. A search of more than 12,000 observations on the water utility benchmarking website, the International Benchmarking Network for Water and Sanitation Utilities (IBNET), indicates that 37 percent of water utilities in the developing world do not even cover operations and maintenance costs from their internal revenue. Overall, political economy analysis provides a practical and useful operational tool that World Bank task team leaders and other urban water specialists can employ in their sector and project work.