In Thailand and Vietnam, faecal sludge (FS) collection and transport services grow spontaneously without adequate business models, causing serious problems to human health and the environment. This study aimed to analyse business problems, business components with financial structure and propose a new conceptual business model. Primary, secondary business data and financial statement reports of 53 service cases were collected and analysed through field surveys, case investigations and questionnaires. The findings revealed the business problems, business components with financial structure of FS collection and transport services. The operation cost structure (7.1 to 13.5 US$/m3) and net profit (−65.8 to 11.1 US$/m3) comparison results suggested that ownership status was related to business performance. A new conceptual business model for FS collection and transport was proposed, comprising infrastructure, service, customer, finance, legislation and ownership. The proposed conceptual business model, qualitatively tested with cases in Finland, Thailand and Vietnam, proved its applicability to improve the FS collection and transport service efficiency in municipalities of low- and middle-income countries.