This study evaluates the financial condition and performance of local water districts (LWDs) in the Philippines. National data show that their consolidated financial performance has improved in the past years. With the government’s aggressive spending program on water infrastructure, lower debt ratios are needed to prepare LWDs to achieve universal access to water supply and sanitation. However, the government’s spending plans are so ambitious that the current balance sheets of LWDs cannot sustain the planned investments financed through debt. This paper shows the significant disparity in water investments across the different regions, resulting in uneven water service coverage throughout the Philippines.