This study focused on the usage of urinals in Kenyan schools and the potential impact of constructing urinals to improve access to school sanitation facilities. Our objectives were: to assess the latrine use patterns for sanitation infrastructure at Kenyan primary schools and to determine the optimal pupil: latrine ratio where adequate urinals are provided. Calculations were based on observation and pupil report. Boys' urinals are relatively inexpensive to construct and maintain, may be longer lasting, require little in the way of behaviour change, and can accommodate a large number of boys at one time. Construction of boys' urinals in order to provide additional latrines for girls may be the most cost-effective, equitable solution in both the short and long term and may offset the cost of more expensive facilities for girls. Access to urinals will help alleviate congestion at latrines, improve conditions, reduce maintenance costs, and sustain latrines longer.