This article examines efforts by the John V. Lindsay administration (1966–1973) to deal with the New York City sanitation crisis of the late 1960s and early 1970s. By this period, the Department of Sanitation could barely function in most low-income neighborhoods of New York City, and this resulted in a series of direct and indirect protest actions. The mass media blamed Mayor Lindsay for the situation and characterized him as an ineffectual city manager. This image has persisted with scholars contending that Lindsay never figured out how to run the city government. This article diverges from these accounts and argues that the Lindsay administration actually rebuilt the Department of Sanitation—a city agency that was operationally breaking down before Lindsay became mayor. In fact, the Lindsay administration popularized the notion that a modern city with global aspirations has to meet the basic spatial needs of its residents and that efficient and responsive sanitation delivery can be achieved through the rationalization of resources and services.