The USAID Lowland WASH Activity adapted Ethiopia’s national Community-Led Total Sanitation and Hygiene (CLTSH) guidelines which have proven effective, albeit imperfect tools when applied in the activity’s implementation regions: Afar; Southern Nations, Nationalities and Peoples (SNNP); and Somali. This Technical Brief details the experience and learnings of the activity implementing CLTSH in pastoralist communities in Ethiopia.