This review paper covers the issues of pit latrine emptying national policies and regulations with a focus on Malawi and Zambia. With 2.4 billion people worldwide still lacking improved sanitation facilities, developing countries need to look at policy, regulation and practice for household sanitation service provision with a new lens. What happens “next,” when improved sanitation facilities eventually become full? An emphasis on faecal sludge management has multiplied this important issue in the past few years. The authors compare the pit latrine emptying situation in Malawi and Zambia with a focus on status, challenges and opportunities. To build this comparison, a desk review of national policies, local regulations and peer-reviewed journal papers was conducted. The paper concludes that existing national policies and regulations taking faecal sludge management into account are weak and have wide gaps in the two study countries. For the future, it is recommended, first, that household pit latrine emptying should be seen as an opportunity to address national sanitation gaps and, second, national policies and regulations need to be evaluated and updated.