Trachoma is prevalent in many arid areas but data assessing the relationship between water use and trachoma are very scarce. This study compared 18 families having one or more active trachoma cases among the children with 16 trachoma-free families in the same village with respect to water use. Potential confounders such as family size, distance to water source, socio-economic indicators, and hygiene behaviour were assessed in the 2 groups. The families with trachoma were found to use significantly less water per person per day for washing children than did the control group (P = 0.033) with no evidence of confounding by the other measured variables. Low amounts of water for washing were also associated with unclean faces and impetigo in the children. If such a relationship can be substantiated it might provide the basis for effective and cheap interventions against trachoma.