This review focuses on how publicexpenditure translates into the delivery of water supply andsanitation services in rural and urban areas in SierraLeone. It describes the legal and institutional frameworkfor the allocation of resources assesses access to WaterSupply and Sanitation (WSS) services and past sectorperformance, and analyzes public expenditure in the sector,including the factors affecting the efficiency of use ofresources, and makes recommendations. Water supply includesthe supply, distribution, and usage of water for drinking,food preparation, and hygiene. Sanitation is defined as thesanitary disposal of liquid waste and the promotion ofhygienic practices. The review covers the period from 2002to 2009, a period of reconstructing after a decade ofupheavals. Since 2002, democracy and a stable environmentfor development have been re-established in the country,especially since the 2007 presidential elections. SierraLeone remains one of the poorest countries in the world.