This study investigated the challenges and opportunities in fecal sludge management (FSM) within Kampala, focusing on the role of Kampala Capital City Authority (KCCA) in managing the city’s sanitation system. A mixed-methods approach, combining surveys and key informant interviews, was employed to gather data from various stakeholders, including KCCA officials, sanitation service providers, and local community members. The study found that inadequate infrastructure, financial constraints, and poor stakeholder coordination were the primary barriers to effective FSM. Infrastructure deficits, such as the lack of adequate treatment facilities and transportation networks, were identified as the most significant challenges. Financial limitations were also found to impede the development of sustainable FSM systems, and poor coordination between stakeholders contributed to inefficiencies in FSM management. A logistic regression model revealed that factors such as infrastructure adequacy, stakeholder coordination, and financial resources were statistically significant predictors of FSM success, with improvements in these areas correlating to higher success rates. Despite these challenges, the study identified promising opportunities for FSM improvement, particularly through the adoption of decentralized treatment systems, community-based management approaches, and increased public- private partnerships. The study concluded that addressing the infrastructure gap, improving stakeholder coordination, and investing in decentralized solutions and capacity building were essential to improving FSM practices in Kampala. Based on these findings, the study recommended enhancing infrastructure development, strengthening coordination among stakeholders, and promoting decentralized systems as key strategies for improving FSM in the city. These recommendations aim to provide practical solutions for overcoming the challenges in Kampala’s FSM system and contribute to the city’s efforts to ensure more sustainable and effective sanitation services.