Many theoretical urban sanitation planning approaches exist, but there is limited evidence of the successful implementation of these approaches, prompting questions about their suitability, especially in complex urban environments in low-income countries. Using primary and secondary data from Lusaka, Zambia, we explore possible limitations of these theoretical planning approaches in informal peri-urban areas. The findings show that while the "enabling environment" aspects stressed by the literature are weak here, these limiting factors are significantly affected by a poor planning culture and inherent dynamics of power, politics and history. A fuller understanding of the local situation is needed to support the transition of planning approaches from theory to reality, so that real progress in sanitation service delivery can be achieved in complex urban environments.