Cities are engines of economic growth that provide spaces for social transformation and political inclusion. Their ability to deliver widely accessible and efficiently functioning public services drives productivity and sustains development. We design and apply an assessment framework to 42 cities in 14 African and Asian countries to better understand the functional, administrative, and political dimensions determining the quality and coverage of water, sanitation, and solid waste collection services. We find that urban local governments are constrained in their authority and discretion to deliver basic public services. Reforming intergovernmental institutional structures to better match responsibilities is essential for realizing cities’ full economic potential.