Sustained functionality of rural water systems is a global challenge. Research on factors contributing to rural water system functionality is largely restricted to hand pumps from single geographies. We analyzed monitoring data from 10 drinking water supply programs in nine sub‐Saharan African and South Asian countries collected between 2017 and 2020. Data included 1,805 randomly selected water points (tap stands, spring protections, rainwater collection, and boreholes and hand‐dug wells with hand pumps) from two cross‐sectional samples: older construction (1–12 years old) and new construction (<1 year). Data collection included observations of water point functionality (“water available”) and management committee questionnaires. Overall, 79% of older construction and 92% of new construction water points were functional. In a mixed effects logistic regression to identify factors contributing to functionality within the older construction sample, piped water tap stands had lower odds of functioning than boreholes with hand pumps (OR = 0.26, 95% CI:0.15–0.46). Water points in communities with fewer available water points, those with operational water management committees (which meet often, collect fees, and can name someone for maintenance), and those with financial savings were associated with higher functionality. As piped water system provision increases in line with international development goals, our results suggest that the benefits of providing higher levels of water service should be carefully considered alongside the technological, institutional, and financial investment required to operate and maintain more complex piped water systems in rural settings.