Background: Water, Sanitation, and Hygiene coordination interventions have been clearly outlined in the country’s policies, strategies, and guidelines developed and implemented over the last few decades. Currently, the program is coordinated by the Directorate under the Ministry of Health program wing. Despite progress, existing coordination structures continue to face challenges in implementing the programs. This study aims to assess existing coordination platforms, identify blockages within the sector coordination platforms, examine major interventions, analyze the persistent challenges affecting coordination, and provide actionable recommendations. Methods: The study employed a qualitative cross-sectional design, utilizing both primary and secondary data sources. The primary target groups for the assessment were key stakeholders in the Water, Sanitation, and Hygiene sectors. The data was analyzed and interpreted in a narrative analysis method through description. Results: To implement the country’s policies and strategies, nationally, more than 10 coordination platforms exist, whereas at the sub-national level, an average of 3 platforms were established in each region, including the Water Sector Working Group and the Hygiene and Environmental Health Steering/ Technical Committee. Another key mechanism is the National Steering and Technical Committees established in April 2016 under the leadership of the health sector, with a signed Memorandum of Understanding and Terms of Reference. The Water and Sanitation Forum was established and organized by the Consortium of Christian Relief and Development Associations to coordinate efforts, address common challenges, and periodically organize learning events to assess the contributions of civil society organizations to the sector. Conclusion: The water, sanitation, and hygiene sector coordination in Ethiopia is best described as a “Government-Led, Multi-Stakeholder Hybrid Model with a very strong hierarchical core. While the structure is a hybrid, the dominant and most aligned theory is Hierarchy, with a secondary and aspirational alignment to the Collaborative Governance model. The priority must be to strategically manage the interfaces—the “handshakes”—between its hierarchical core, its network platforms, its emergency response system, and its informal “shadow” networks. Leveraging the strengths of each while mitigating their friction points is essential for building a resilient, adaptive, and effective sector capable of accelerating progress towards global commitments.