This article is about a partially untold story: the central role played by intermediate or ‘meso’ institutions in urban water supply. Three central functions are identified: translating policies and laws into operational targets; monitoring; and incentivizing operators. This paper considers which aspects of institutional design and capacity allow meso-institutions to perform these functions successfully, and conversely what constrains them from doing so. It explores this issue through a careful examination of urban water provision in seven Asian cities which represent a range of macro-institutional environments and micro-institutional arrangements. The analysis shows that in many cases meso functions are performed inadequately or not at all for water supply, with negative consequences for the quality of service. This is particularly evident in cases where ownership and decision rights are not clearly defined and allocated.