A regional scoping study has reviewed the limited data on groundwater use for 10 cities in Tropical Africa. In those cities where the water utility has been able to develop groundwater rationally, the public water-supply usually offers a better service at lower cost by enabling phased investment and avoiding advanced treatment, and offers greater water-source security in drought and from pollution. Urban dwellers obtain water from multiple sources, according to availability and affordability. Among the more affluent, private water-supply boreholes are increasingly used to improve security and reduce cost but in the absence of international charity finance groundwater access is beyond the financial reach of the urban poor, except where the water table is shallow allowing the use of low-cost dugwells. The way forward must be to integrate more effectively utility and private investments, and piped and non-piped solutions, for urban water-supply provision, and for water utilities to establish low-income (‘pro-poor’) policy and technical units to pursue ways of supporting alternative water-supply provision, including advisory services and regulatory functions (where appropriate) for private borehole and dugwell use. To facilitate this, water utilities will need to partner with resource regulators and knowledge centres, which may require modifications to their mandate.