Wastewater infrastructure operates largely out of sight—but when systems fail, the consequences are immediate and measurable: untreated discharges, regulatory violations, degraded waterways, and risks to public health. Across the country, many communities face the same underlying pressures: aging infrastructure, increasingly stringent environmental requirements, and limited local resources to fund long-term system improvements. These case studies demonstrate how private, regulated wastewater providers across a diverse set of communities are consistently leading in wastewater system transformation—demonstrating that even long-standing wastewater challenges can be resolved through long-term investment and operational excellence.