This essay examines sanitation workers who work with solid waste management and analyses their ability to create a sustainable livelihood based on livelihood assets and strategies. The study was undertaken in Babati, Tanzania and a qualitative method was applied, consisting of interviews and observations. The main findings were that sanitation workers employed four livelihood strategies, however, only two of these were sustainable and contributed towards a positive livelihood outcome. Multiple stresses were identified, such as low wages, inability to save money, unsafe work conditions, exposure to bacteria and other contaminants and no access to social services. Shocks were identified as work-related injuries resulting in extended time off work, wages being paid out late and sudden illness. This made the sanitation workers terms of employment in Babati almost equivalent to that of waste workers and waste pickers in the informal sector, despite being employed by the local government authorities. As a result, the workers were not able to attain a sustainable livelihood and the livelihood outcome appear to be a vicious cycle of debt and vulnerability. A key characteristic for this study is its examination of Tanzania’s political context and institutional framework as important factors that affect the sanitation workers’ resource base and strategies as well as their exposure to vulnerabilities.