Though most commonly regarded as a revolutionary public health invention, the introduction of conventional wastewater sanitation systems has a mixed legacy in the U.S. A growing body of research links sewage-based sanitation systems with nationwide ecosystem degradation and an unsustainable dependence on vast inputs of materials and resources. In addition to contributing to chronic problems across the country, today these wastewater infrastructures are in various states of disrepair. The EPA estimates that at least $270 billion must be invested in coming years to prevent massive sanitary failures, but municipalities are increasingly unable to fund these expensive (re)investments in buried water-carriage sanitation infrastructures. Some U.S. communities are exploring the potential for community-scale decentralized sustainable or ecological sanitation (ecosan) solutions to meet their sanitary needs at a fraction of the cost of wastewater treatment schemes and with various additional benefits. This thesis examines the first two pilot applications of community ecosan in the New England region of the U.S. to understand the opportunities, challenges, and adaptation strategies that characterize these projects in the North American context. An emergent, mixed methods approach was developed over several years and involved personal engagement with the cases reviewed. The two pilot projects are compared and contrasted, and several themes are identified: First, the case studies indicate that specific conditions may have provided fertile contexts for the introduction of community-scale ecosan in the U.S. Second, various challenges have been posed to large scale ecosan projects in the U.S, but existing sanitary regulations and funding pathways present the most formidable barriers since they often deter innovative solutions. Third, these cases show that communities can develop myriad strategies to overcome these challenges and confront barriers to sanitation reform in the U.S. The study is framed by an inquiry into the role of professional planners and local community members in sustainable sanitation reforms. Findings indicate that individual planners can react both positively and negatively to proposals for community ecosan schemes, and that planners possess numerous tools to support community-led programs in navigating the significant barriers they face. Ultimately, though, communities must practice self-determination in sanitation reform planning. Final recommendations suggest that future community ecosan projects focus on incremental and complementary introduction, integrate research components, and incorporate effective ecosan residuals management schemes into their programming.