Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings.