Access to a clean, safe, and affordable water supply for domestic use is a fundamental human right. However, in many urban areas in sub-Saharan African countries, including Tanzania, not all people have access to water due to the operation, maintenance, and sustainability challenges of the built infrastructure. This study assessed factors affecting the sustainability of the Borehole water project in Dodoma Region, taking a case of Nghong'onha ward in the City Council of Dodoma. Specifically, the study focused on household water use practices and examined the factors affecting the sustainability of borehole water projects. The study used both primary and secondary data of a quantitative and qualitative nature collected through interviews, observations, and a documentary review. This study employed probability and non-probability sampling techniques to select a sample of respondents and key informants. The collected data were analysed for descriptive statistics such as frequencies and means and binary logistic regression analysis, whereas qualitative data were analysed using the qualitative content analysis technique. The study found that, on average, households consumed 82.27 litres of water daily, and 47.5% of respondents had to wait for 31–45 minutes to fetch water at the water point. Furthermore, findings revealed that community meetings (0.000), distance to water points (0.000), water facility spare parts availability (0.054), payment modality (0.023), and annual maintenance (0.011) significantly affected borehole water project sustainability. The study recommends that interventions to improve access to domestic water supply in the study area should focus on improving water supply infrastructure and the built infrastructure's operation, maintenance, and sustainability.