The exigency for a comprehensive infectious waste management program in hospitals is influenced by federal guidelines and concern about the public image of our hospitals as a source of environmental pollution. The need to discard infectious waste in an aesthetically acceptable manner that will prevent hazards from injury and/or infection has received some recognition, but many states have not promulgated regulations on infectious waste management. Realizing the critical environmental health problems posed by improper disposal of infectious and other hazardous waste, Congress charged the Environmental Protection Agency (EPA) with the responsibility of formulating “cradle-to-grave” regulations over hazardous waste by requiring implementation of Subtitle C of the Resource Conservation and Recovery Act of 1976. Waste with infectious characteristics that may “pose a substantial present or potential hazard to human health or the environment when improperly … managed” are considered by this Act as hazardous waste. While by definition infectious waste is considered a subset of hazardous waste, the EPA has not yet issued regulations to fulfill the Congressional mandate to establish a management system for infectious waste. It has, however, prepared a technical manual which is intended to assist hospitals and states so they may establish appropriate programs and/or regulations on infectious waste management. This commentary will review some of the principles, practices, problems, products and services associated with infectious waste management.