In recent years, global health advocates have proposed to “Reinvent the Toilet.” Such a device would provide complete and effective treatment of human waste, unconnected to any sewer or drainage network and operated with minimal water and energy. Delegates from 30 countries have met for the last two years to develop a new ISO standard for “non-sewered sanitation devices” (NSSDs). NSSDs are anticipated to meet critical public health needs in developing countries with limited water and wastewater infrastructure. However, this new standard carries important implications for North America as well. From national parks to shopping malls, high-tech toilets meeting the new ISO standard could upend our approach to sanitation and our expectations about future water use and wastewater infrastructure.