Given the implementation of the Sanitation and Hygiene (S&H) policy in the Southern Nations Nationalities and Peoples Region (SNNPR) of Ethiopia, this paper reviews the progress made to date. This study examines the effects of the post-2003 S&H policy that was implemented by the Bureau of Health, in SNNPR, with the view to draw lessons that could inform similar policies in other regions of Ethiopia and beyond. Central to this analysis, is an examination of socio-cultural, technical and policy/institutional issues surrounding the S&H policy. This study was conducted in Mirab Abaya woreda and Alaba special woreda and employed both quantitative and qualitative research methods. Results indicate that the post-2003 policy on S&H was very successful in increasing latrine coverage, and this could be replicated elsewhere in Ethiopia and beyond. However to achieve sustainable S&H conditions, and behavioural change, some areas need attention and further support. These include latrine technology options and construction materials, positioning of latrines, hand washing facilities, hand washing with soap, and safe water handling.