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Background Soil-transmitted helminth (STH) infections are one of the most prevalent neglected tropical diseases in the world. Drug treatment is the preferred method for infection control yet reinfection occurs rapidly, so water and sanitation represent important complementary barriers to transmission. Methods A cross-sectional study was conducted to observe STH risk factors in rural Rwandan households in relation to the Sustainable Development Goal for water and sanitation service levels. Survey and observation data were collected from 270 households and 67 water sources in rural Rwanda and were processed in relation to broader risk factors identified from the literature for the role of water and sanitation in STH infection pathways. Results A significant association between higher water and sanitation service levels and lower STH infection risk profiles was found for both water and sanitation. However, variability existed within service level classifications. Conclusions Greater granularity within service level assessments is required to more precisely assess the efficacy of water and sanitation interventions in reducing STH infection risks. [ABSTRACT FROM AUTHOR]