In low- and middle-income country (LMIC) contexts such as Sub-Saharan Africa and South Asia, between 44 percent to 51 percent of urban populations are unserved by piped water and 72 percent to 84 percent lack sewered connections. A significant proportion of this population is likely served by small, local providers (SLPs). Despite the ubiquity of SLPs, existing programs and studies largely ignore the impacts these stakeholders have on service delivery. This study, produced by USAID’s URBAN WASH, aimed to understand the characteristics of SLP service provision and possible approaches for cities to formally leverage SLPs in expanding coverage of drinking water and fecal sludge management (FSM) services in LMICs. A framework was developed that cities can use to implement market transitions and formally leverage SLPs.