This paper provides a neighborhood-specific study of the social effects of poor sanitation in a poor neighborhood in a developing country city, Accra. It examines the challenges of rapid urbanization with respect to sanitation and waste management, and the burdens placed on poor urban residents in Sabon Zongo, a poor community in Accra. Like many poor communities in Accra and other large Ghanaian cities, residents of Sabon Zongo unable to queue and pay for sanitation services tend to package their liquid and solid waste in plastic bags and dump them indiscriminately within the community. The paper argues that the inability of city authorities to deal with sanitation and waste management in the poor urban community of Sabon Zongo go beyond the much discussed issue of health. This is because the inadequacy of sanitation and waste management in this particular poor urban settlement also has social implications. The paper concludes that while slums and poor urban communities may exhibit certain similar characteristics, they are not homogenous. Neighborhood-specific research such as the present study on Sabon Zongo offers opportunities for analyzing and understanding the internal dynamics, and the key stakeholders at the community level – critical conditions for tapping into the energies of residents toward addressing the challenges of sanitation and waste management in poor urban communities in Accra.