Natural disasters have increasinglydamaged water supply and sanitation (WSS) facilities andinfrastructure, leaving entire communities without safe andreliable drinking water and the appropriate disposal ofwastewater. These emergency events could arise frominundation of facilities, loss of electricity, and exposureand disruption of infrastructures. Less severe impacts canarise from increased siltation of reservoirs and slow-onsetevents such as droughts, thus having longer-term effects onthe resilience and reliability of services. These WSSservice failures or interruptions could set off a cascadingeffect across interconnected infrastructure systemsincluding public health and fire services, which in turncould pose both direct and indirect economic impacts. Japanhas built the resilience of its WSS services through anadaptive management approach based on lessons learned frompast natural disasters. This experience offers key insightsfor low- and middle-income countries seeking to sustain andbuild resilience of WSS services.