Water scarcity and non-existent or poor sanitation have special implications for the poor in a rural context of a developing country such as India, especially in the case of women due to their personal hygiene needs. The penetration of sanitary napkins is very low in Indian villages for reasons such as the high cost of branded napkins, availability, and cultural barriers. Over 88% of rural women use unhygienic alternatives during menstruation, with 77% using a piece of old cloth and many others nothing at all. These practices lead to a deterioration in health of the mother as well as the child and, sometimes, the death of the mother. Furthermore, a large proportion of girls in India do not go to school during their menstruation period, for an average of 4–5 days every month, and at least 23% of girls drop out of school when they start menstruating. Adult women cut down on their productive day-to-day activities. Menstruating lower-income women also have to follow certain social exclusion norms and treat it as a purely private matter as it is considered a social taboo. The access to personal reproductive hygiene products and services thus becomes indispensable in terms of addressing hygiene and sanitation needs. Furthermore, this is more of a developmental/social venture rather than just pure rural marketing. This paper examines the issue from a social enterprise and social innovation perspective in order to understand the issues involved in changing the situation. It examines the case of a social venture in India (Goonj) which has attempted to deal with this market in terms of its approach, product design, market creation, performance, issues faced, and impact made. The paper attempts to infer lessons for making social entrepreneurship and social innovations work in developing country health and hygiene contexts in the form of a Bottom of Pyramid (BoP) market solution.