The Malawi Social Action Fund (MASAF) introduced Community Driven Development (CDD) approach in the implementation of community projects in urban areas in 2003. This was aimed at alleviating urban poverty by allowing communities to demand projects that address their priority needs. This study examined the nature of participation in CDD and its contributions to improving accessibility of services among the urban poor in Lilongwe City. Both qualitative and quantitative data from three purposively sampled neighborhoods revealed that participation was low and passive. The study also found that participation is determined by socio-economic characteristics of the urban poor. These include: period of residence, ownership of a house, ethnicity, politics, age and source of income, level of education and gender. It was also found that agents of development like Community Based Organizations (CBOs), Community Development Committees (CDCs), Water Users Associations (WUAs), community and political leaders initiate and mobilize resources for community projects. However, some agents misappropriate public funds meant to benefit vulnerable groups and personalize projects upon receipt of funding. The study also established that community projects in poor urban neighborhoods are implemented without following physical development plans. This causes land use conflicts that affect sustainability and accessibility of public services. Besides, the requirement to pay for services under the veil of decentralization makes them inaccessible to the urban poor. The study recommends promotion of public awareness on decentralization and CDD among the urban poor; promoting group learning by networking urban community organizations; financing community projects that benefit the poor; building capacity for monitoring transparency and accountability in managing community projects and integrating CDD in urban planning to encourage community participation in urban development planning and implementation processes.