The disposal of clinical wastes is often poorly conducted and inadequately supervised despite the publication of clear and definitive working guidelines and the introduction of increasingly stringent legislative control. The move away from landfill disposal of clinical wastes, and the further development of high temperature incinerators able to meet increasingly tight emission limits, is to be applauded but has inevitably increased the cost of waste disposal. Moreover, such developments fail to address the continuing 'shop floor' problems whereby wastes enter an inappropriate waste stream or colour coded wastes containers are used for inappropriate purposes thus undermining the value of a nationally approved hazard warning policy. The development of newer waste treatments, including microwave exposure of macerated wastes, may reduce costs and aid in the control of environmental pollution. However, stringent control of this and existing technologies remains essential. Additionally, increasing resources must be directed to improvements in primary waste disposal practices whereby all health care staff have a clear responsibility to ensure correct disposal of wastes without risk to themselves, their colleagues and others, or to the environment.