In Italy, the debate about the reform process, that has involved the water sector for several years, cannot be considered concluded. It seems exclusively ideological and often it does not consider the business administration perspective, which certainly could make a contribution to the solution of different problems. Politicians and researchers, for example, show very little interest for the economic and financial performance of water utility firms, focusing almost exclusively on the different ways for providing the services or on the ownership structure. This work analyzes the variables characterizing the outsourcing process in the water sector. It also explores the connection of such variables with the performance of companies and local government authorities involved in the delivery process. Subsequently, the work explains the results of an exploratory analysis of different cases in the international context, making also a comparison about the performance. Lastly, the work verifies the existence of some best practices and evaluates the adaptability of these best practices in the Italian context.