Water and excreta related diseases such as diarrhoea and other respiratory problems remain a major health concern in Bangladesh and people in the Hard-to- Reach (HtR) areas i.e. vulnerable geomorphologic areas and slipping population from all sorts of development activities suffer more. Much effort have already been undertaken to promote decentralized and sustainable context-specific sanitation facilities through increasing the capacity of the vulnerable community and creating their access to services. However, more activities and effort is needed to ensure the appropriate sanitation facilities for all, mainly in the HtR areas. Besides design of proper context-specific sanitation technologies, safe human excreta disposal is also crucial for preventing the spread of infectious diseases as the thickness of surface impermeable clay and depth to groundwater table play vital role to select the distance between pit-latrine- the source of pathogen bacteria, and shallow tubewell. The study was undertaken to evaluate the efficiency of existing sanitation technologies in the geomorphologically variable HtR areas. Five different HtR areas i.e. drought prone, flood prone, char (sand bar), coastal and haor (swamp) areas were selected for the survey. The study reveals that context specific technologies and designs are required for the sustainability of sanitation services in the vulnerable areas.