This article focuses on the problem of Islamic boarding schools failing to foster and create a healthy environment in the physical environment of the boarding school. Some Islamic boarding schools are still vulnerable to providing clean water and have environmental sanitation problems. This paper aims to explain why these problems can occur in the Islamic boarding school environment, how the efforts of Islamic boarding schools to overcome these problems are experienced by Islamic boarding schools, and what obstacles are experienced by Islamic boarding schools in realizing a sanitary environment. This study was conducted on a small scale, namely at the Darut Taqwa Ngalah Islamic Boarding School in Pasuruan Regency, East Java. This study uses a case study approach in the data collection process, with observation and interview techniques. The results showed that the problem of environmental sanitation in Islamic boarding schools is a complex problem because it is triggered by various factors, namely the physical, social and cultural environment. These factors are interrelated and cannot be separated from each other in shaping the behavior of students who are less clean and healthy.