In order to reach the Millennium Development Goals for significantly reducing the number of people without access to adequate sanitation, new holistic concepts are needed focusing on economically feasible closed-loop ecological sanitation systems rather than on expensive end-of-pipe technologies. An analysis of a former civilization in the Amazon (nowadays Brazil) highlights the possibility to close the loop with a more sustainable lifestyle integrating soil fertility, food security, waste management, water protection and sanitation, renewable energy. Terra Preta do Indio is the anthropogenic black soil produced by ancient cultures through the conversion of bio-waste, fecal matter and charcoal into long-term fertile soils. These soils have maintained high amounts of organic carbon several thousand years after they were abandoned. Deriving from these concepts, Terra Preta Sanitation (TPS) has been re-developed and adopted. TPS includes urine diversion, addition of a charcoal mixture and is based on lactic-acid-fermentation with subsequent vermicomposting. Lacto-fermentation is a biological anaerobic process that generates a pre-stabilization of the mixture. The main advantage of lacto-fermentation is that no gas and no odor is produced. What makes it particularly interesting for in-house systems even in urban areas. Instead, vermicomposting is an aerobic decomposition process of the pre-digested materials by the combined action of earthworms and microorganisms. It transforms the carbon and nutrients into the deep black, fertile and stable soil that can be utilized in agriculture. No water, ventilation or external energy is OPEN ACCESS Sustainability 2014, 6 1329 required. Starting from ancient Amazonian civilizations traditional knowledge, the aim of this work is to present TPS systems adopted nowadays.