Developing countries are constantly and continuously confronted with a myriad of health and environmental problems that threaten the efforts to establish and maintain safe air and water supplies. Nigeria, in general, and Akwa Ibom State, in particular, are not isolated from increasing health and sanitation problems. My goal in this study was to determine the knowledge base of men and women related to sanitation and environmental health in Akwa Ibom State. I found no differences in the attitudes of men and women toward the sustainability of health or a healthy environment in the state. However, more sanitation and environmental education is needed as part of long-term strategy for abating sanitation and environmental health problems in this state.