Successfully addressing the complex global sanitation problem is a massive undertaking. Anaerobic digestion (AD), coupled with post-treatment, has been identified as a promising technology to contribute to meeting this goal. It offers multiple benefits to the end users, such as the potential inactivation of pathogenic microorganisms in waste and the recovery of resources, including renewable energy and nutrients. This feature article provides an overview of the most frequently applied AD systems for decentralized communities and low-and lower-middleincome countries with an emphasis on sanitation, including technologies for which pathogen inactivation was considered during the design. Challenges to AD use are then identified, such as experience, economics, knowledge/training of personnel and users, and stakeholder analysis. Finally, accelerators for AD implementation are noted, such as the inclusion of field studies in academic journals, analysis of emerging contaminants, the use of sanitation toolboxes and life cycle assessment in design, incorporation of artificial intelligence in monitoring, and expansion of undergraduate and graduate curricula focused on Water, Sanitation, and Hygiene (WASH).