Untreated wastewater is used informally for irrigation in many developing countries. This use needs to be managed to reduce the risks while maintaining its benefits. This paper documents the experience and lessons from a project in Rajshahi, Bangladesh, that aimed to do this. In line with the ‘multi-barrier approach’ advocated by the World Health Organization, a learning alliance approach was adopted whereby local stakeholders were brought together to analyse the issues, and implement a participatory action plan to deal effectively with the wastewater problem. The process resulted in negotiation between parties that rarely communicated previously and led to demand-driven actions including engineering solutions, policy review and community awareness programmes. While it built capacity and resulted in integrated solutions, it was resource intensive, and as the work is recent its sustainability is yet to be reviewed. This approach could facilitate stakeholders to effectively tackle wastewater reuse if certain constraints are overcome.