This study focused on designing a drinking water systems sustainability index for Integrated Water Resources Management in low-income countries. Water Supply Systems Sustainability Index (WSSI), a field assessment tool, was designed for rapid appraisal of drinking water systems in selected urban, peri-urban and rural Nigerian communities. The systems were classified into Highly Sustainable, Sustainable, Averagely Sustainable, and Unsustainable WSSI categories. Sanitary Risk Score (SRS) was assigned, classifying drinking water systems into Very High, High, Intermediate (Medium) and Low-Risk categories. WSSI results revealed that for urban systems, 90 are Highly Sustainable, 27 are Sustainable and 12 are Averagely Sustainable. For peri-urban systems, 13 are Highly Sustainable, 7 Sustainable and 1 Averagely Sustainable. Only urban hand-dug wells are in the Very High-Risk category. Public water supplies occurred only in the Low-Risk (17) and Intermediate-Risk (6) categories. Urban and rural boreholes had better quality than peri-urban boreholes. WSSI and SRS correlation result indicated strong positive correlation for urban hand-dug wells' (R2 = 0.5688, at p < 0.05) and weak positive correlation between peri-urban hand-dug wells' (R2 = 0.1847, at p < 0.05) and urban boreholes' WSSI and SRS (R2 = 0.2032, at p < 0.05). Findings showed that drinking water systems are, generally, sustainable and WSSI could be incorporated into community-level water supply assessment.