The antiepileptic drug carbamazepine is a useful anthropogenic marker in groundwater to detect and quantify sewer exfiltration. In 2003 its application on a city wide scale enabled the identification of a trunk sewer in extremely bad structural status with an exfiltration (of wastewater into groundwater) rate in the adjacent area of around 5% compared to an average of approximately 1% in other parts of the city. After a reconstruction of the trunk sewer investigations were carried out again in 2008. Due to the reconstruction a decrease in exfiltration to roughly 3% could be achieved, which equals a reduction of exfiltration by about 45%. Thus carbamazepine emerged as suitable anthropogenic marker to assess sewer exfiltration and to evaluate the success of reconstruction measurements on a regional scale.