At the request of the USAID Regional Housing and Urban Development Office in Tunis, The Water and Sanitation for Health (WASH) Project conducted an exploratory study with the goal of elaborating a national strategy on the subject of sewage disposal in areas not served by the Tunisian National Office of Sanitation. Specifically, the purpose of this exploratory study was to assess the sewage disposal situation in urban areas not served by the National Office of Sanitation and establish a process for formulating a national sewage disposal strategy for the development and promulgation of alternative disposal methods in Tunisia.