Technological innovation has become central to enhancing efficiency, transparency, and accountability in public service delivery, particularly in the sanitation sector of developing countries. This study assessed the effect of technological factors on sustainable sanitation service delivery, drawing insights from Kenya’s Nationwide RealTime Monitoring Information System (RTMIS) under the Ministry of Health. Anchored on the sustainability theory and supported by institutional Theory, stakeholder theory and resource-based view theory, the study adopted a descriptive and explanatory research design combining quantitative and qualitative methods. Data were collected from 394 respondents, including Community Health Promoters, County Health Officers, and RTMIS administrators, through questionnaires and key informant interviews. Descriptive and regression analyses were conducted using SPSS version 27. Findings revealed that technological innovation significantly influenced sustainable sanitation service delivery (β = 0.412, p < 0.05), explaining 31.6% of the variance in service sustainability. Key factors included automation, interoperability, and digital infrastructure, while limited user training and system maintenance constrained effectiveness. The study concludes that technological innovation enhances sustainability when supported by institutional commitment, reliable infrastructure, and user capacity. It recommends policy reforms to strengthen digital infrastructure, regular user training, and dedicated funding for RTMIS maintenance to ensure long-term functionality and data-driven sanitation governance in Kenya.