The Water and Sanitation Program undertook this study to conduct evidence based research to help advocacy in the sanitation sector. The study aims to empirically estimate the economic impacts of current poor sanitation conditions in Pakistan as well as the economic benefits of options for improved conditions. The study’s ultimate goal is to provide policy makers at both national and local levels with evidence to justify larger investments in improving the sanitation conditions in the country. It also provides recommendations, again based on empirical evidence, for effectively planning and implementing sustainable sanitation and hygiene programs.