Theoretically, water supply, sanitation and poverty are intertwined. This intertwined link is governed by various socio-economic, political and cultural factors. In Pakistan, this interlink is very strong. This paper is designed to assess the extent of this link and to evaluate various options of interventions and their effectiveness. Data analysis suggests that the sector suffers from poor attributes of access, quality, coverage and expenditure constraints. Sector’s review indicates that approaches, strategies and priorities suffer from a number of problems. Results imply that water and sanitation approaches are less likely to work well or very effective.At least the approaches are not sustainable in the long run till the situation of the poor people will not be changed. Improvement could only be possible where the services are targeted efficiently with better access with low cost technologies coupled with improved pro-poor financial mechanisms. This can be achieved by extending the services to the income poor and water and sanitation poor and by extending the services in rural areas such as schools where the lack of facilities are visible.