South Africa is moving towards a more water-efficient sanitation system, with several innovative technologies emerging. This research looked at the technical performance of water-efficient pedestals against a testing protocol developed based on international best practice. The research found that there are water-efficient pedestals with flush volumes of 0.6 to 5.5 L that are suitable for use in a range of South African contexts. These pedestals can remove simulated faeces and a range of anal cleansing material and ensure that material is moved along up to 10 m of drainage pipework. The research also found that the adoption of water-efficient pedestals could reduce average dry weather sewer flow by 23%. The widespread adoption of water-efficient pedestals could have a significant impact on the water savings in South Africa. This could help to reduce the pressure on water resources and make water more available for other uses.