This study examines the sustainability of rural drinking water supply (DWS) projects installed by non government organizations (NGOs), international non government organizations (INGOs) and government organizations (GOs) in two districts in the mid-hill region of Nepal. Comparative analyses of different systems installed by NGOs, INGOs and GOs, which portray the work and improvements needed for sustainability, are determined. This study shows that INGO installed projects are moving forward to sustainability in terms of performance compared to NGOs and GOs. One of the prime reasons of failure to maintain sustainability is poor involvement of women from the projects' early stages. A systematic random household survey was conducted of selected projects in the study area and this showed that most of the rural DWS projects need to improve management practices and gender equality during planning as well as operation and maintenance phases. Rural people are satisfied with DWS project water availability in their communities. Results indicate that water accessibility fails to have significant impacts on rural livelihood especially for the rural poor.