The influx of Forcibly Displaced Myanmar Nationals (FDMN) into Bangladesh has necessitated the development of robust Fecal Sludge Management (FSM) strategies in Cox’s Bazar to ensure safe and sustainable sanitation solutions. Effective fecal sludge management (FSM) is crucial in humanitarian settings for public health, environmental protection, and dignity. This study investigates comprehensive FSM strategies in Cox’s Bazar Rohingya refugee camps, one of the largest and most complex humanitarian crises. Using a mixed-methods approach, it combines quantitative data from surveys and field observations with qualitative insights from interviews and document analysis to examine the FSM value chain, including sludge production, containment, collection/emptying, transport, treatment, and disposal/reuse. Findings show high sludge production rates require frequent desludging, with challenges in containment due to structural weaknesses and privacy concerns. Collection and emptying face logistical and health issues, while transport is hindered by difficult terrain and limited vehicle availability. Treatment facilities are often inadequate, leading to operational challenges and environmental risks. Despite these issues, disposal and reuse practices in agriculture show promise but need safety and community acceptance improvements. The study recommends increasing desludging capacity, enhancing containment designs, improving transport infrastructure, expanding treatment facilities, and promoting safe disposal and reuse practices. Emphasizing community engagement, technological innovations, and coordinated efforts among stakeholders is crucial for sustainable FSM systems. Future research should focus on innovative technologies, long-term sustainability, and scalability of FSM strategies across contexts. This research provides valuable insights and practical recommendations for improving sanitation in similar emergency contexts worldwide.