The life expectancy and mortality rate of the country majorly depends on its domestic water supply and basic sanitation. In Ethiopia, especially in rural areas, where people still rely on unimproved water sources for domestic purposes, thewater supply may be contaminated with waterborne and water related diseases. The current study was carried out in rural kebeles of Fagita Lekoma District of Awi zone in Amhara region to assess thewater supply and sanitation. To address the objective, household surveys, field observation, focus group discussions and key informant interviews were conducted and analyzed. Both descriptive and qualitative methods were used to collect the primary and secondary data. To process, analyze and interpret the results of the data collected in 2013 EC from 150 household heads of rural kebeles, statistical package for social sciences (SPSS-23) program was used. In the district, around 25 % get access to water which is treated by chlorine. However, the rest which comprises almost 75% of the households get water from unprotected traditional hand dug wells, springs, and rivers which are contaminated water sources. These groups of the dwellers are highly exposed to water born disease. The majority of people in the district rural areas do not use the improved water schemes due to its inadequacy, long walking distance and long waiting time. The consequences of unimproved water use were in general negatively affecting the environment, health and economic development ofa rural community in the district. An access to basic sanitation was also another challenging issue to these groups of the community. Around 76 percent of the community do not have pit latrine while the rest 24 percent have pit latrine. Generally, both poor accessibility of domestic water supply and sanitation were negatively affecting qualitatively on the environment, health and economic conditions of the district area. Key words: Access to water, Development, mortality, sanitation, unimproved water, waterborne disease