In many cities, the emptying, conveyance, treatment and disposal of fecal sludge has largely been left to unregulated private, informal service providers. To address this neglected but crucial part of urban sanitation, the World Bank has developed some tools to diagnose fecal sludge management (FSM) status and to guide decision-making. These tools don’t provide pre-defined solutions, as the many variables and stakeholders involved demand interventions specific in each city, and should be seen within the context of integrated urban water management.