Manual pit-emptying – the removal of faecal sludge from pits and tanks using hands or basic tools – is a widespread practice in Bangladesh, and in other low- and middle-income countries. Despite this, little is known about the livelihoods of pit-emptiers. This paper analyses data from six cases of pit-emptying in three cities in Bangladesh, across three different operational modes: private cooperatives, government employees and self-employed workers. These cases describe the experiences of emptiers from diverse socio-economic, religious and ethnic backgrounds, operating across a formal–informal spectrum. We find that government employees and self-employed groups are deprived of basic rights, fear a loss of income brought about by mechanisation and cannot access alternative livelihoods. While the status of emptiers in private cooperatives has improved recently due to the support of governmental oranisations (GOs) and non-governmental organisations (NGOs), the extent to which these cooperatives are sustainable, without the ongoing support of NGOs or GOs, remains unclear. In all modes, sustainable livelihoods are hindered by deep-rooted social and financial barriers. Organisations can support pit-emptiers by designing sanitation interventions that prioritise the human right to decent work, focussing not only on the beneficiaries of universal sanitation, but also on those who work to implement this ambitious goal.