Sarah E A Long: A Feasibility Study of 21st-Century Sanitation in North Carolina (Under the direction of Jamie Bartram) There is growing recognition among practitioners and government officials, of the human right to safe water and sanitation. As the United States of America invests in its water and sanitation infrastructure over the next decade, it is worth exploring opportunities to the limitations of conventional systems. Sewer systems are costly to install and maintain, while septic systems are prone to poor maintenance and made challenging by not suitable soil conditions. Inspired by examples of sanitation innovation abroad, I explore what a 21st century sanitation system, that both meets sanitation gaps and improves upon conventional systems, would look like in the U.S. using the case of the state of North Carolina. I conducted a literature review of sanitation alternatives and conceptualized the design of a system that meets the health, economic, and environmental needs of a range of communities within the state. I conducted qualitative analysis of a series of interviews to examine incentives, barriers, and perceptions among key stakeholders. I explored the financial feasibility of such a system, for communities in North Carolina with a range of available resources. Results suggest that the primary incentives for a conceptualized alternative are environmental, and economic, particularly in comparison to septic systems. The biggest advantage over septic systems would be the decreased minimum lot size due to the elimination of a septic drain field. The conceptualized alternative’s capital costs are estimated to be cheaper than both sewer and septic; however, maintenance and lifetime costs were higher than the conceptualized systems, making the alternative’s overall costs more expensive. The potential for resource recovery and retrofitting existing infrastructure are, however, promising. The stakeholder responses to the conceptualized design warrant further exploration of this conceptualized system.