Some of the most important basic services provided by any level of government are the primary responsibility of municipalities, and urban managers devote more time and attention in making sure that these services are delivered. The availability of public services in any local jurisdiction usually depends on location, history, laws and regulations. Some local governments use alternative service delivery such as public-private partnerships, intergovernmental agreements, and contracting out or privatization. Using an exploratory case study approach, this paper provides a comparative analysis of water and wastewater services in Romania and the United States. Six cities were selected from both countries for illustration purposes. In sum, the analysis concludes with recommendations on how to improve as well as measure the efficiency and effectiveness of municipal water and wastewater services in Romania and the United States.