This paper examines the contribution that local water and sanitation companies make in delivering services to the urban poor. All too often, the debate on private sector participation has centred on international companies, failing to recognize the importance and prevalence of local water and sanitation companies. This paper assesses the differences between multinational, local/national and micro/informal private sector water and sanitation service providers, and goes on to outline the range of different local water and sanitation companies currently operating, which includes those operating water and sewerage utilities, independent networks, and the provision of water tankers and suction trucks for sewage disposal. The paper concludes that more consideration should be given to local companies, including a review of existing laws and regulations, in order to improve their ability to deliver services equitably and efficiently.