This paper reports about the results of an evaluation of selected sanitation systems in India. The following sanitation systems were evaluated: septic tanks, communal Ecosan systems, biogas toilets, solid immobilized biofilters, multiple stage filtration and decentralized wastewater treatment systems (DEWATS). The evaluation has been based on an initial assessment looking at whether the systems comply with their intended benefits, and more in depth evaluations on cultural, economic and/or hygienic aspects where the initial assessment has not provided sufficient knowledge. The evaluation showed that all sanitation systems were well accepted by the users. The highest hygienic risk is present in septic tanks, where sludge handling poses a high risk for persons handling it.