Plasmid pBI143 has recently been identified as being highly abundant in the human gut microbiome, suggesting potential as a fecal water quality indicator and normalization marker in wastewater-based surveillance. We evaluated the relative concentration efficiency and spatial−temporal distribution in raw wastewater to inform its development as a marker. The results showed significantly higher (p < 0.01) enrichment in raw wastewater solids (mean of 9.2 × 10 7 GC/mL) than in liquid fractions [mean of 2.3 × 10 6 genome copies (GC)/mL]. The relative concentration efficiencies were 28% for nanotrap particles, 23% for Amicon ultrafiltration, 3.6% for pH drop and filtration, 4% for skim milk flocculation, and 0.04% for poly(ethylene glycol) precipitation compared to direct wastewater extraction. DNase pretreatment reduced pBI143 levels by 90.3%, indicating that it is mainly extracellular in raw wastewater. Over 21 days, pBI143 levels remained stable and were consistently a mean of 1.3 log 10 higher than other fecal indicators (Carjivirus, PMMoV, and HF183). In raw wastewater from eight states (n = 16), pBI143 concentrations averaged 2.2 × 10 6 GC/mL (95% confidence interval of 1.7−2.7 × 10 6 ) and pBI143 was detected in all samples. The findings support pBI143's potential as a fecal indicator and normalization marker, though further validation is needed to confirm its specificity to humans.