The implementation of the Belo Monte Hydroelectric Power Plant was tied to compensation and social and environmental conditions, with the universalization of basic sanitation in the city of Altamira, in the state of Pará, being the highlight of this study. The city's physical, social, cultural and environmental space has changed as a result of the implementation of this project. The aim of this research was to investigate and describe the expansion of basic sanitation services – that is, water supply, collection and treatment of domestic sewage, and solid waste – in the city of Altamira between 2010 and 2022. The analyses used secondary data on basic sanitation obtained from the 2010 Demographic Census and primary data collected in a survey applied to 500 households in the city of Altamira in 2022. A documentation analysis was also carried out of the Basic Environmental Project for the Belo Monte Hydroelectric Power Plant and the Altamira Integrated Municipal Basic Sanitation Plan. A review of the literature related to the problem was also carried out. Despite the significant improvements and positive results for the environment and public health, it was observed that the condition of universalization of basic sanitation services in the city of Altamira was not achieved. The governance of these services has encountered obstacles between the municipality and the Belo Monte developer, in the context of the implementation, expansion and transfer of services. With regard to the problems associated with governance, we would highlight the discussion about who would be responsible for carrying out the intra-household water and sewage connections, the population's historical dissatisfaction with the water supply services, the residents' resistance to accepting the intra-household water and sewage connections and the flaws in the planning of the executive project. These implications substantially affected the capacity to expand and the quality of these basic services to the population of the city of Altamira.
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