Background: Although sanitation policies have been implemented in many areas, there are still many challenges, such as limited infrastructure, lack of public awareness, and limited budgets for adequate sanitation management. Pangkep Regency, with its growing population, faces serious sanitation problems, especially in urban areas and densely populated neighbourhoods. Methods: This qualitative study aims to explore in depth the perceptions of the community and policy makers regarding the implementation of public sanitation policies and their impact on environmental health in urban areas of Pangkep Regency. Findings: The findings of this study show that although sanitation policies have been implemented in Pangkep Regency, their implementation still faces various obstacles. As many as 40% of sanitation facilities in urban areas do not meet hygiene and safety standards, while 60% of sanitation facilities in densely populated neighbourhoods experience problems in managing liquid waste and garbage, which has the potential to pollute the environment. Conclusion: Some of the main problems found are limited sanitation infrastructure, lack of public awareness, and limited funds, which affect the success of sanitation policies. Novelty/Originality of this article: This article focuses on sanitation conditions in Pangkep Regency, directly analysing the obstacles, impacts, and challenges of sanitation policies in urban areas and densely populated neighbourhoods. This study highlights the importance of adequate sanitation infrastructure in the success of policies and links the lack of proper sanitation facilities to the high prevalence of sanitation-related diseases.