The Government of India launched the Swachh Bharat Mission (SBM) in 2014 with the ambitious aim to ensure hygiene, waste management and sanitation across the nation by the 150th anniversary of Gandhi’s birth in October 2019. This document aims to build on existing knowledge by detailing how the challenge of achieving universal sanitation and Open Defecation Free (ODF) status has been approached by Visakhapatnam in Andhra Pradesh, presenting nine stepping stones which together constitute a pathway towards citywide ODF status.