Globally, approximately 1.8 billion people, mainly in low- and middle-income countries, use a source of drinking water that suffers from microbial contamination. This includes piped water supplies (Bain et al., 2014). There exists an urgent need to improve access to water supply services and to replace aging water and sanitation network infrastructure. In an effort to do so, private sector participation, mainly in the form of Public-Private Partnerships (PPPs), has been increasingly used to help improve efficiency, access to, and quality of water services. The first wave of PPPs led by multinational operators was met with a fair amount of backlash. The growth in PPPs since has seen a significant shift towards PPPs led by local private water operators. However, extant research has used theoretical frameworks and constructs that were developed during the multinational era and are failing to explain and predict PPP outcomes today. For the prevailing local-dominated context, a new theoretical framework is developed and suggests more relevant constructs and indicators, such as operator localness, informal renegotiations, and contract transfers, to assess contract fate in water sector public-private partnerships. Grounded theory, cross-case comparison, and fuzzy set Qualitative Comparative Analysis (fsQCA) are used to build theory and suggest potential causal combinations leading to contract persistence and cancellation in water PPPs. Counter to the dominant theory in the literature, the analysis finds that a combination of operator localness, informal contractual supports, and contract transfers impact persistence. The findings build on our understanding of the viability of water PPPs and has implications for structuring, managing, and assessing private sector engagement in water service delivery in low- and middle-income countries. This dissertation focuses on Latin America as it has comparatively high levels of PPP experience globally and has been a focus of extant literature on water PPP renegotiations, cancellations, and performance (Andres, Guasch, Haven, & Foster, 2008; Guasch et al., 2017, 2008, 2003; Marin, 2009a; Marin et al., 2010). Argentina, especially, has implemented an ambitious water PPP program with variation in operator localness and in contract outcomes.