Water, sanitation and hygiene (WASH) are vital indicators to healthy living and safe environments for child development. The aim of the study was to determine WASH status and practices in ECD centres located in low socio-economic areas of Nelson Mandela Bay during 2017. This cross-sectional study elicited responses from 46 ECD centres which had a total of 3,254 children and 172 caregivers. A structured questionnaire and visual observation were used. Using core WASH in schools' indicators (WinS) showed that despite improved water sources being available in 91% of the facilities, WinS for hygiene was poor. The study observed that 57% of the respondents had improved toilets accommodating both genders. In 29% of ECD centres, 6–10 children make use of a ‘pottie’ while in 9% of the cases, more than 20 children make use of one ‘pottie’. The use of the bucket system was noted in 22% of the ECD centres. In 79% of the ECD centres, children wash their hands in a communal plastic bowl. Only 11% of the study population washed hands hygienically under a running tap or tippy tap. WASH conditions in the ECD centres in the study area require urgent attention and further investigation for practical solutions.