This paper discusses the implementation of Tiger Worm Toilets (TWTs) as a sustainable alternative to pit latrines in areas with challenging environmental conditions. The study was carried out in Koinadugu, Sierra Leone, where TWTs were installed in 200 households, providing safe sanitation for approximately 1,200 individuals within a 17-month period. The study reveals that TWTs offer several benefits over traditional pit latrines, including higher cost efficiency. Despite some setbacks, TWTs have been well-received by the local communities, resulting in a significant reduction in open defaecation in areas where latrines are not viable. The study presents areas of further research and concludes with recommendations for future TWT designs based on the lessons learned.