Sanitation work in Pakistan is disproportionately assigned to non-Muslims who belong to so-called “lower castes”, often without real choice in the matter. This report explores how communities in Pakistan that are marginalized due to their caste and religious identities experience compounded discrimination in Pakistan’s sanitation sector. Pakistani authorities must abide by international human rights law and standards and extend rights to sanitation workers without discrimination on the basis of class, caste and religion through specific legislative action to address caste-based discrimination, treating sewerage work as hazardous and ensuring effective implementation of labour laws to sanitation work.