Elected officials and policy analysts alike often treat equity and efficiency as distinct concerns. In this case study, focusing on U.S. policy for disposing of low-level radioactive waste, we consider an instance where the distinction between equity and efficiency is difficult to sustain. The ''equity, then efficiency'' approach embodied in the compact system of regional agreements is largely to blame for the current crisis facing generators, regulatory officials, and citizens. We find that nearly three times more waste disposal facilities are being contemplated than are financially viable. More generally, it is claimed that the approach for achieving an equitable solution must be very carefully designed, and that the concept of economic efficiency must be considered (at least in this case study) as part of the definition of equity. This case study is unusual, because we are able to make a recommendation that improves both efficiency and equity.