South Africa’s private sector and the practice of using market processes are often dismissed by the government as service providing options, because they increase costs and fail the poor population. There is some substance to the government’s position, given that there is a natural monopoly advantage in water service provision. Under these circumstances it could be expected that a single firm would emerge as dominant in the provision of these services to urban customers. Were this firm a private one, and unregulated, it could be expected to practice exploitative pricing, make excess profits, and undersupply waste water management service. A private firm would also not provide services to the poor unless their service was subsidised. However most of these deficiencies can be regulated (as shown in Chapter Four), and also occur under public sector provision (as shown in Chapter Five) Are the private sector failures sufficient reason to abandon the market and private sector as mechanisms to deliver water service in South Africa? This dissertation finds little use is made of market processes and the private sector in water service provision (Chapter One), despite there being legal provision for such involvement (Chapter Two). It also finds that public water service providers are not subject to competition policy and consumer protection provisions, whereas private sector providers would be (Chapter Three). The administration of questionnaires to municipalities and the Department of Water Affairs (DWA) show that the various water service providers often operate under unique circumstances, making it difficult to extrapolate management insights from one municipality to another (Chapter Six). A case study on Nelson Mandela Bay Municipal tariff setting reveals a mismatch between economic principle and policy practice, and suggests that economic principle plays a lesser role in the design of tariff structures than other factors (Chapter Seven). Given the problems that are occurring in public sector water service provision, the dissertation concludes the case for dismissing private sector or public utility models for water service delivery may be weaker than is believed by the South African government.