Despite all efforts and significant investment in the sanitation sector; sub-Saharan Africa is far behind its Millennium Development Goal (MDG) target. Community led total sanitation (CLTS) is a concept that revisits all the past approaches, particularly the promotion of household sanitation within the context of basic human dignity. CLTS emphasises community facilitation to assess their sanitation situation and promotes natural leaders. CLTS supports community action plans developed under their leadership. The main yardstick of CLTS achievement is totally open defecation free (ODF) villages and not numbers of toilets. This paper reviews Plan's experiences of promoting CLTS in Eastern and Southern African Countries. The potential of CLTS addressing the issue of scale and long term sustainability within the national planning framework is recognised and lessons learnt from ongoing programs in Ethiopia and Tanzania are shared. The challenges and some limitations of CLTS are critically assessed by this paper and issues needing more research and studies are presented.