The human right to clean water and sanitation is currently under discussion in the European Union. During this discussion, it should not be forgotten that another European organisation, namely the European Court of Human Rights (ECtHR), is becoming increasingly active regarding pan-European minimum standards relating to the right to clean water and sanitation. Although it is widely recognised that clean drinking water and sanitation are essential to the realisation of all human rights, no such obligation can be found in the European Convention on Human Rights (ECHR). This article reviews the creative development of the jurisprudence of the ECtHR concerning the right to clean water and sanitation using two interpretation techniques, namely the ‘living instrument’ doctrine and the ‘practical and effective’ doctrine. Today, the ECtHR recognises, for example, that a breach of a State's obligation to respect the right to water can amount to a violation of Article 3 of the Convention on inhuman or degrading treatment. By failing to oblige companies to curb water pollution, the Court has also held that a State can be liable for a breach of Article 8 of the Convention, namely the right to respect for private and family life.