This paper examines municipal solid waste management in Uganda under the decentralisation policy. The aim is to analyse devolved solid waste management and the constraints on achieving sustainable waste management. To achieve the objectives, waste characteristics, generation rate, collection, disposal and stakeholder roles and waste management responsibilities were analysed. Results indicate the waste is predominantly biodegradable (78%) with generation rate of 0.55 (0.3–0.66) kg/capita/day and collection coverage of 43.7%. Urban Councils are under capacity to handle waste management demands and where services are poor or nonexistent the community have developed onsite waste management methods. Waste recovery, recycling, re-use, and composting are being practiced by the urban community. The national strategy for solid waste management is failing because environmental management is not mainstreamed into local development plans and weak resource mobilisation, due to the lack of fiscal decentralisation and lack of participatory approach to the decentralisation process. Waste management receives less than 10% of urban council budgets compared to other policy areas. In conclusion, for effective waste management there is need for genuine decentralisation where urban councils are empowered, have capacity for resource mobilisation and apply participatory planning.