Three years after Zaatari camp was established in the Hashemite Kingdom of Jordan, to host Syrian refugees, its population has grown to 82,000 persons. Zaatari is one of the largest refugee camps in the world, in one of the most water scarce areas on earth. Since its establishment, drinking water has been delivered by trucks to communal facilities across the camp. Wastewater is trucked out from these facilities, and from unregulated, self-constructed wastewater storages next to family households. In order to improve long-term sustainability in all aspects: equitable water and sanitation access, public health risks and environmental impact and operational costs, water and sewage systems with household connections are being implemented. In this shift from emergency to sustainable phase, urban infrastructure selection and design methods were found to be beneficial and adapted for the situation. Aspects such as stakeholder management and project management, throughout design and implementation phases, are vital and similar to the planning processes of urban water utilities. Potential for further sustainability lies in the development of operation and maintenance and administrative strategy to reflect and maximise the significant investment. Therefore, a shift is necessary from a humanitarian approach toward a more structured vision based on master planning. Quality control of the entire process and outputs requires a project management unit. The long term master planning perspective of urban development and urban utility perspective of operational sustainability is determined to be essential in the conception of water and sanitation schemes in Zaatari refugee camp