This document discusses emerging small towns and the need for new approaches to sustainable water, sanitation, and hygiene (WASH) services. It notes that small towns, defined as having populations between 5,000-50,000 people, are growing rapidly in number and size but often lack formal WASH services. Conventional urban and rural approaches do not meet the unique characteristics of small towns. The research found that small towns require tailored solutions and support through broader town-wide development planning, defined generic factors at national and sub-national levels, and a menu of context-appropriate technical, financial and management options.