This study explores the potential of prepaid meters for serving urban poor communities. It provides urban utilities, oversight agencies, and other stakeholders in Africa with a basis for decision-making on the suitability, introduction, and management of such meters. The need for the assessment emerged from prepaid meters increasingly being utilized by water and sanitation utilities in developing countries, including World Bank clients. The technologies adopted have expanded over this period, but there has been a lack of consolidated data and analysis that capture the service delivery, operational efficiency, and access to services aspects of such systems across utilities and regions systematically.