Sanitation and hygiene management began in Togo with the removal of household waste in 1974 under the responsibility of Lomé City Council. Since then, a host of public and private policies and programs relating to sanitation and public hygiene have been implemented with a view to achieving a healthy and livable environment, especially in cities. Despite these efforts, it appears that in almost all Togolese towns, the problem of uncleanliness is becoming more widespread and worrying. Using a methodological approach that is both qualitative and quantitative, with questionnaires, structured interviews, and field observations, this research presents the various factors that explain the persistence of urban uncleanliness and possible solutions relating to the new system in terms of innovations to be implemented for sustainable urban sanitation. Notable factors include the weak culture of eco-citizenship among city dwellers, the irregularity of household waste collection services, and the high cost of household waste collection services. In terms of the new system to be implemented to solve the problem of unsanitary conditions, it is necessary to focus on ecocitizenship. Decision-makers must recognize the crisis of citizenship by promoting ecocitizen values and practices to ensure the sustainability of urban sanitation.