The idea of implementing ancient water and wastewater technologies in the developing world is a persuasive one, since ancient systems had many features which would constitute sustainable and decentralised water and sanitation (WATSAN) provision in contemporary terminology. Latest figures indicate 2.6 billion people do not use improved sanitation and 1.1 billion practise open defecation, thus there is a huge need for sustainable and cost-effective WATSAN facilities, particularly in cities of the developing world. The objective of this study was to discuss and evaluate the applicability of selected ancient WATSAN systems for the contemporary developing world. Selected WATSAN systems in ancient Mesopotamia, the Indus Valley, Egypt, Greece, Rome and the Yucatan peninsula are briefly introduced and then discussed in the context of the developing world. One relevant aspect is that public latrines and baths were not only a part of daily life in ancient Rome but also a focal point for socialising. As such they would appear to represent a model of how to promote use and acceptance of modern community toilets and ablution blocks. Although public or community toilets are not classified as improved sanitation by WHO/UNICEF, this is a debatable premise since examples such as Durban, South Africa, illustrate how community toilets continue to represent a WATSAN solution for urban areas with high population density. Meanwhile, given the need for dry sanitation technologies, toilets based on the production of enriched Terra Preta soil have potential applications in urban and rural agriculture and warrant further investigation.