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A successful national program to assure sanitary quality of molluscan shellfish requires a multi-disciplinary and multi-agency governmental training, data collection, policy development and management effort in collaboration with members of the shellfish industry. The Tanbi Wetlands and other estuaries of Gambia support shellfisheries for oysters, Crassostrea tulipa, and the senile ark, Senelia senilis, conducted by the TRY Oyster Women’s Association. With low shellfish prices and a small local market, a Gambian National Shellfish Sanitation Program (GNSSP) was begun as a means to boost consumer confidence and allow market access to Gambia’s robust seasonal international tourism trade. Gambian officials began training with a study tour to Rhode Island to work with counterpart officials engaged in administering the US-NSSP. Since August 2010, water was sampled bimonthly for total (TC) and fecal coliforms (FC) at stations near shellfish harvesting areas. Sanitary shoreline surveys began on 18 June 2011 to document sources of contamination and to establish priorities for remediation. Conclusions were 1) sanitary shoreline surveys identified numerous point contamination sources, 2) FC is a superior indicator of fecal contamination than TC, 3) FC values from most shellfish growing areas met or exceeded a FC standard of 14 MPN/100 ml most of the year, indicating clean growing waters, 4) highest average FC values corresponded to local rainfall maxima from July to October during the traditional off-season for shellfishing, 5) sanitary remediation (e.g. introduction of sanitary latrines at Old Jeshwang) resulted in localized water quality improvement and 6) there is enough data precision and repeatability to establish and map water quality classification zones. In areas without sanitation or near a dumpsite, FC values indicate a prohibited zone, but areas away from settlements could be certified year-around harvest sites. Postharvest shellfish sanitation and cold chain management from harvest to market remain as the key challenge of the GNSSP.