Sanitation is an important index of socio-economic development. Low sanitation levels lead to a host of diseases, making sanitation a key public health issue and concomitant of a clean water supply. Based on field work in two urban slums of Hyderabad, Andhra Pradesh, this article points out that sanitation implies much more than defecation issues and that it converges on several important aspects of life, such as shame and dignity and personal hygiene. Women themselves defined what is appropriate sanitation. Cleaning tasks are primarily performed by women who receive little support from men. We argue for the need to give women a central role in decision-making, designing, planning and implementation of sanitation programmes. Women’s definitions of the minimum standards of hygienic practices are clearly brought out by the study.