A field study assessing the sustainability and efficacy of 55 biosand filters installed during 1999–2010 was conducted in the Artibonite Valley, Haiti during 2011. Twenty-nine filters were still in use. Duration of filter use ranged from < 1 to 12 years. Water quality, microbial analysis, and flow rate were evaluated for each functioning filter. Kaplan- Meier analysis of filter lifespans showed that filter use remained high (> 85%) up to seven years after installation. Several filters were still in use after 12 years, which is longer than documented in any previous study. Filtered water from 25 filters (86%) contained Escherichia coli concentrations of < 10 most probable number of coliforms/100 mL. Recontamination of stored filtered water was negligible. Bacterial removal efficiency was 1.1 log10. Comparable results from previous studies in the same region and elsewhere show that biosand filter technology continues to be an effective and sustainable water treatment method in developing countries worldwide.