This study examined urban space management in Manaus via the Municipal Basic Sanitation Plan (PMSB), emphasizing the disparity between its planning and actual implementation. Despite progress in water supply, the city ranks 87th in the national sanitation index and exhibits low sewage treatment rates, undermining public health, quality of life, and environmental sustainability. The central research question evaluates the PMSB’s effectiveness in advancing Manaus toward universal service coverage. Employing a qualitative and exploratory method, the study conducted a literature review using scientific platforms alongside documentary analysis of official reports and the PMSB itself. The findings indicated that, although the plan constitutes an institutional advancement, it is limited by outdated data and lack of integration among the four components of basic sanitation. The study observed that improvements in water supply have not been accompanied by corresponding expansions in sewage infrastructure, highlighting an imbalance in service provision and the need to reinforce planning and monitoring strategies. The lack of current assessments impedes the development of actions aligned with national objectives and the Sustainable Development Goals, particularly SDG 6. Thus, revising the PMSB offers an opportunity to prioritize effective public policies, address historical inequalities, and uphold the right to basic sanitation in Manaus.