This article presents the experience of using the Community-Led Total Sanitation (CLTS) approach in a recent programme in Somalia and explains some of the adaptations that were necessary to adjust to the specifics of a fragile and insecure context. The article goes on to explore the applicability of CLTS in fragile and insecure contexts more generally, using examples from South Sudan, Chad, and Afghanistan, and argues that in some ways it is an ideal approach for overcoming some of the challenges of working in these areas. During more than 20 years of civil conflict in Somalia, sanitation interventions were mostly limited to construction of latrines for affected populations or education on sanitation and hygiene (using the Participatory Hygiene and Sanitation Transformation (PHAST) approach) followed by fully subsidized latrine programmes for selected households. There is little evidence that these interventions achieved any real results, and recent surveys in Somalia show that sanitation access has actually decreased between 1995 and 2012. Open defecation levels are very high with correspondingly high levels of diarrhoea and frequent outbreaks of cholera. This is exacerbated by the high costs associated with construction of improved latrines due to logistical difficulties in transporting construction materials through insecure areas to remote communities, which discouraged many actors from carrying out comprehensive sanitation programmes in the past. With this background and encouraged by experiences in Afghanistan and other post-conflict contexts, UNICEF and partners decided to experiment with CLTS. These experiments came at a time when other water and sanitation actors were exploring the broader applicability of more demand-driven approaches in fragile and post-emergency situations.