Informal settlements are home to over one billion people worldwide and are characterised by high population densities and poor environmental conditions. The authors identify the impact of COVID-19 on existing water and sanitation practices and potential pathways for transmission of COVID-19 in informal settlements in India and Indonesia. In the short term, there is an urgent need for mobile hand washing, washing/bathing facilities and toilets. In the long term, COVID-19 provides an opportunity to invest in centralised water and sanitation networked solutions appropriated for high-density settings to integrate those settlements into the city, improve environmental conditions and health in cities.