Ethiopia met the MDG target for drinking water access with a unique and high degree of success. Its development approach was informed (and still is today) by successful transformations in the “Asian Tigers” of Malaysia, Vietnam, Singapore, South Korea, Thailand, and Taiwan between the 1960s and 1980s. The magnitude of the country’s success in providing improved drinking water to nearly half of its population in 25 years despite its diversity, size, and challenges cannot be overstated. This case study documents the progress of the Ethiopian WASH sector from 1990 to 2015, and analyzes the impact of local systems created in Ethiopia to respond to water and sanitation challenges.