Background: Countries in Europe and North America managed to control and eradicate most of the infectious parasitic diseases that occur in the first half of the twentieth century. Nevertheless, infectious and parasitic diseases are still present in certain metropolitan areas of Brazil, despite the increased prevalence of chronic diseases. This work aims to present the general aspects of the situation of diseases related to inadequate environmental sanitation (IESDs) and the sanitation policy of Porto Alegre. Objective: The general objective was to examine the public policy for environmental sanitation in Porto Alegre, and the specific objectives were: I) to analyse the relationship between indicators of poverty and inadequate environmental sanitation and the occurrence of diseases-related to inadequate environmental sanitation; and, II) to present the situation of IESDs and the sanitation policy of Porto Alegre. Methods: The method was qualitative and quantitative, with data collection and analysis of public policies. The period analyzed was from 2008 to 2012. Data were obtained from Health Information Systems, DATASUS website of the Ministry of Health, along with a set of basic indicators from the Porto Alegre’s Observatory. The indicators were classified according to the specific objectives: poverty (P); environmental sanitation (S); diseases (D). Pearson's linear correlation coefficient was used for statistical analysis to test the associations between poverty and basic sanitation indicators with IESDs indicators. Results: The results showed that the biggest problems related to IESDs occur in the poorest regions, which are: Restinga, Parthenon, Nordeste, Lomba do Pinheiro, Gloria, Ilhas, and Extremo Sul. The higher concentration of Dengue was found in the Parthenon region; Leptospirosis in the regions of Restinga, Extremo Sul, Lomba do Pinheiro, Norte and Eixo Baltazar; Hepatitis A in the regions of Ilhas, Nordeste, Humaitá /Navegantes, Centro, Lomba do Pinheiro, Norte, Leste and Parthenon. Regarding the public policy for Environmental Sanitation in Porto Alegre, we concluded that there are some urban policies, but the subject needs greater systemic view directed to the most specific problems of the city. About the Sanitation Plans, we concluded that the regions that need sanitation, at most - a sewage collection network - have lower footage for infrastructure installation, such as the region of Ilhas. The sanitation basic plan (Water) gives various information about areas that need the implementation of infrastructures of universal supply, however, there is still no date of when that will be possible. Conclusion: Finally, infectious and parasitic diseases are a reality in Porto Alegre. Still, in the XXI century, there are about 1,200 annual hospitalizations in health services (SUS) which are responsible for about 750 deaths per year in the capital city.