With over 100 million people without access to sewage collection and treatment and over 35 million lacking access to piped drinking water, the water and sanitation services (WSS) sector in Brazil ranks last among all the infrastructure sectors. Despite previous efforts to reach universal coverage, the gap remains wide. In order to reduce this gap, the Brazilian Parliament approved the reform of the WSS sector in July 2020. This paper examines the state of the water and sanitation services in Brazil before 2020 as well as the potential effects of the recently approved reform. It demonstrates that the sector’s primary issues are the fragmented institutional arrangements and regulations, the low levels of investments by the public sector, including those made by State-owned water companies, and the barriers to entry for the private sector. The paper also discusses the new provisions included in the reform designed to remedy those issues. The authors believe that the reform has the potential to promote significant changes in the structure of the WSS towards providing a universal and equitable service in Brazil, but at a slower pace than the reformers anticipated.