Sanitation remains one of the Sustainable Development Goals, with slow progress. Tanzania has been implementing the National Sanitation Campaign through a Community-Led Total Sanitation (CLTS) approach since 2012. Njombe District Council (DC) has been identified to be among the best performing councils in the implementation of the sanitation campaign. A qualitative study was conducted to document how the CLTS was carried out in Njombe DC, assess progress on CLTS implementation and define the success factors for CLTS implementation. Findings show that CLTS intervention has resulted in increased coverage of improved latrines at a household level from 7.5% before the intervention in 2011 to 99.8% in September 2018. In addition, households with functional hand washing facilities have increased from 5.1% before the intervention to 94% in September 2018. Involvement of political leaders and government officials from the council level to the lowest governmental unit offered important support for CLTS implementation. The best mix of sanitation education, regulation and enforcement was instrumental in raising community awareness, changing collective behavior, making people comply with the village sanitation laws, and the overall success in the sanitation campaign.