The paper discusses the status of water supply and sanitation infrastructure in Opole County (poviat) on the basis of results of a survey conducted in 2016 and official statistical data. Opole County is located in the northwestern part of the Lubelskie Voivodeship, Poland, and covers an area of 810 km2. It comprises five rural communes: Chodel, Józefów nad Wisłą, Karczmiska, Łaziska and Wilków, and two urban-rural communes: Opole Lubelskie and Poniatowa. On average, 89.5% of the County’s inhabitants have access to a mains water supply network, but only 32.8% are connected to a centralized sewerage system. In almost all of the County’s communes, there is a disproportion in coverage between the water supply and sewerage networks. The water supply coverage for the individual communes ranges between 88.9–99.6%, while the sanitation coverage level does not exceed 20%. One exception is the commune of Poniatowa, where the disproportion is negligible, with 87.7% of the inhabitants having access to running water and 73.3% to sanitation services. In 2016, Opole County had eight centralized wastewater treatment plants with a total capacity of approximately 8,470 m3/d. According to the survey data, there were 6,946 cesspools in the County in 2016. In the future, they should be replaced with highly efficient domestic wastewater treatment plants. In 2016, there were 84 on-site domestic wastewater treatment plants in Opole County. However, they were all systems with a drainfield, a technology that poses a huge threat to the soil and water environments. The present study shows there is a great need for investment in expanding the sanitation infrastructure and replacing the existing cesspools.