This research demonstrates the existence of inequitable outcomes in provision of piped water services by both private and other service providers in rural Vietnam. This study is the first of its kind in Vietnam, providing robust scientific evidence on who accesses water services from private enterprises. Qualitative research in 60 communes was followed by a quantitative study in six locations. A policy and regulatory review was also conducted, in addition to an assessment of enterprise motivators, enablers and challenges. The study highlights the need for effective regulatory mechanisms to ensure inclusive water service delivery in rural Vietnam.