Africa’s urban population is growingrapidly. Between 2000 and 2015, the urban populationincreased by more than 80 percent from 206 million to 373million people. Although access to piped water increasedover the period (from 82 million urban dwellers with pipedwater in 2000 to 124 million in 2015), African utilitieswere not able to keep up with the rapid urbanization asreflected in the decline of piped water as a primary sourceof water supply in percentage terms. The objective of thisassessment is to inform Bank and government policies andprojects on the drivers of utility performance. The reportdescribes the main outcomes and lessons learned from theassessment that identified and analyzed the main features ofwater utility performance in Africa. The report includes thefollowing chapters: chapter one gives introduction, chaptertwo describes the methodology used in the study, includingdetails on the data collection process. In chapter three,the study team undertook a trend analysis of utilityperformance of the sector. Chapter four examines theefficiency of utilities using a data envelopment analysis(DEA) while also using an absolute performance approach.Chapter five investigates the effect of institutionalfactors on utility performance. Chapter six presents aneconometric analysis of the drivers of utility performance,using various definitions of utility performance. Theresults from the econometric models are triangulated with aset of case studies of five utilities (Burkina Faso’sl’Office National de l’Eau et de l’Assainissement (ONEA),Cote d’Ivoire’s la société de distribution d’eau de la Côted’Ivoire (SODECI), Kenya’s Nairobi City Water and SewerageCompany (NCWSC), Senegal’s Sénégalaise des Eaux (SDE), andUganda’s National Water and Sewerage Corporation (NWSC),similar to those that the electricity study team undertook,which are presented in chapter seven. The report concludesin chapter eight with the lessons learned from the assessment.