Participatory approaches are an important component of institutional frameworks for the governance of water resources and services. Studies on public participation in water management provide evidence for the outcomes of public participation and insights into the types of methods and the contexts under which participation can be meaningful. However, participatory processes are complex, and there is no single method by which to interpret, approach and implement them. This paper explores elements from the theory and practice of participation, applied to the management of water resources and water and sanitation services. Based on an in-depth literature review, we analyze the forms of participation in water and sanitation, their outcomes, as well as the contextual factors and procedural elements of participatory processes that affect their success. Contextual factors are those that are largely outside of the control of agencies or participants (e.g., demographics, history, and culture) or those that can only be influenced by management and institutional decisions in the mid- and long-term (e.g., the legal and institutional framework); while procedural elements are those over which agencies and participants have considerable control when designing and executing participatory efforts (e.g., representativeness and inclusivity, access to information, and opportunity to influence). We propose a framework that interrelates and integrates both contextual factors and procedural elements of participation. It, includes three additional aspects that are influenced by, and in turn influence, the context and the process: existing capacities for implementation of meaningful participatory processes, the resources that are allocated to them, and attitudes towards participatory processes. The framework helps conceptualize what we call the enabling environment for active, free, and meaningful participation in the delivery of water and sanitation services. By breaking down the complexities of participation, the framework supports practitioners and decision-makers to better design and implement participatory processes in water resources and water and sanitation services.