This review examines the social and political roots and ongoing implications of centralized, waterborne sewerage. This system has served as a marker of class, a signal of wealth and political power, and a mechanism of social reform. As sewerage networks ballooned in the mid‐19th century throughout Europe and North America in response to a growing public health movement, their use and attendant hygiene practices served to intertwine physical and moral hygiene. The new infrastructure prioritized a felt distance between the user and their excreta, particularly signaled by the absence of odor, access to privacy, and the disassociation of users from any part of the management process beyond the flush of the toilet. Furthermore, the resource intensive system advertised affluence, and emphasized emerging notions of the networked urban space, which had the potential to tame and control Nature. This infrastructure model and its social and political underpinnings were exported to many cities under colonial influence throughout much of the 19th and 20th centuries, and were used to justify class differentiation and racialized agendas. Differential sewerage access in municipal centers of the Global South today continues to serve as a marker of class distinction, and many modern scholars explore how lack of sewerage renders the urban poor politically invisible. Ultimately, consideration of the social and political legacy of the linear sewerage system may offer new ways forward in addressing urban sanitation crises faced across the globe today, including problems posed by aging, unsustainable, and insufficient infrastructure. WIREs Water 2016, 3:63–73. doi: 10.1002/wat2.1108This article is categorized under: Human Water > Value of Water