A devastating cholera epidemic swept Zimbabwe in 2008, causing over 90,000 cases, and leaving more than 4,000 dead. The epidemic raged predominantly in urban areas, and the cause could be traced to the slow deterioration of Zimbabwe's water and sewerage utilities during the economic and political crisis that had gripped the country since the late 1990s. Rapid improvement was needed if the country was to avoid another cholera outbreak. In this context, donors, development agencies and government departments joined forces to work in a unique partnership, and to implement a programme of swift improvements that went beyond emergency humanitarian aid but did not require the time or massive investment associated with full-scale urban rehabilitation. The interventions ranged from supply of water treatment chemicals and sewer rods to advocacy and policy advice. The authors analyse the factors that made the programme effective and the challenges that partners faced. The case of Zimbabwe offers valuable lessons for other countries transitioning from emergency to development, and particularly those that need to take rapid action to upgrade failing urban systems. It illustrates that there is a ‘middle path’ between short-term humanitarian aid delivered in urban areas and large-scale urban rehabilitation, which can provide timely and highly effective results.