The need for taking a comprehensive perspective when selecting sanitation technologies in developing contexts has been increasingly discussed. Process guides, which are planning documents describing steps decision-makers need to take, represent one possible contribution to attain comprehensive decisions. An interview study with sanitation experts was carried out to understand the importance and real use of such planning documents for the selection of urban sanitation technologies in developing countries, as well as to understand the relevance and actual consideration of decision elements and to identify recommendations for taking them into account. Although process guides appear to be helpful to guide planning processes, their use does not seem to be common practice. It is actually doubtful that the sector is currently able to make better use of those documents in the form that they exist today. Furthermore, the importance of a comprehensive approach is generally recognised, but relevant decision elements were said to be often neglected. Finally, results from the interview analysis also emphasised the need for a conducive policy environment, namely by developing appropriate institutional and legal frameworks, and by incentivising planners and decision-makers to further adapt to comprehensive decision-making practices that effectively improve the sanitation situation in developing countries.