This article examines the development and implementation of Municipal Basic Sanitation Plans (PMSB) in the Upper West Region of the Brazilian Northeastern state of Rio Grande do Norte. The investigation reveals that, despite the legal requirement for PMSB, many municipalities encounter significant challenges, including a dearth of trained personnel and financial resources, insufficient public engagement, and the absence of a unified information system for basic sanitation policy. Moreover, the lack of budget provisions for executing the actions outlined in the plans was identified as a critical issue. The article concludes that it is essential to fortify planning processes, ensure public participation, furnish the requisite technical and financial capacity, integrate basic sanitation actions into municipal budgetary frameworks, and address the political disarticulation of small municipalities.