We examined the availability and accessibility of water, sanitation, and hygiene (WASH), and the overall ‘WASH’ performance in terms of levels, trends and inequality across the six cities (Mumbai, Delhi, Chennai, Bangalore, Kolkata, and Hyderabad) of India using data from two rounds of the India Human Development Survey conducted during 2004-05 and 2011-12. Findings summarise that accessibility and overall WASH performance during 2011-12 were better than 2004–05. The change was not significant across cities in terms of WASH availability during the survey years. The availability of WASH was poor, but accessibility was better in Mumbai. Chennai reported a reverse trend, where availability was better, but accessibility was poor. The overall level of WASH became significantly better in Mumbai during 2011-12 compared to 2004-05, but changes were minor in other cities. The cities with poor WASH performance (Kolkata, Hyderabad, and Chennai) exhibited more inequality compared to better performing cities (Mumbai, Bangalore, and Delhi). The intra-city inequality is attributable to housing conditions, economic status, educational level, socio-religious affiliation, and occupational status. The efficiency with equity in WASH performance – both between and within cities should be the prioritised issue for urban policies to make cities more socially inclusive and sustainable.