The United Nations General Assembly has declared access to water and sanitation as a fundamental human right, yet development of infrastructure for the provision of water and sanitation is problematic in developing nations including Ghana. Water and sanitation infrastructure are local assets upon which national public interests for sustainable development rest. Investments in potable drinking water and sanitation may yield high economic dividends and improved health. It is globally recognised that water and sanitation improvements are critical in achieving the Millennium Development Goals (MDGs) on reducing child mortality, promoting gender equality and reducing endemic diseases such as malaria and diarrhoea. Ghana’s population without access to improved water sources declined from 44 percent in 1990 to 16.2 percent in 2008. Thus, Ghana is on track to achieving the MDGs target of reducing the population without access to improved water and sanitation sources ahead of the target date of 2015. However, inadequate investment in water and sanitation infrastructure exists. Evidence shows disparities in improved water and sanitation access between urban and rural areas as well as between various regions in the country. This paper, which largely relies on secondary data, discusses water and sanitation infrastructure gaps in Ghana. It recommends the need for specific targeted interventions to address the water and sanitation infrastructure gaps, and calls on the central and local governments, private sector and civil society organisations to work in concert to address the problem in order to attain sustainable development.