As the fourth phase of the Three Gorges reservoir project commenced in 2008, the rate of water flow in the Yangtze River has obviously decelerated further downstream and water clarity within the storage facility has decreased. Meanwhile, the rate of urbanization in the region is adding to the amount of municipal solid waste (MSW) being generated by every day life. The composition of the waste is becoming more diversified and complicated, thereby presenting an increasing threat to the ecological environment and water resources of the Three Gorges region. This paper is a probe into MSW in terms of its characteristics as well as methods of storage, collection, transportation, recycling, treatment and disposal, the protection of environmental ecosystems. Municipal solid waste management (MSWM) is one of the major environmental problems in the Three Gorges region, and indeed the whole of China. Based on the analysis of the present situation of MSWM and its treatment/disposal, some methods of sorting, recycling, decomposing, incineration and reuse are described, sanitary landfill as the main disposal method in Chongqing city, incineration being the second. Sanitary landfill or dump was also used for MSW treatment in the Three Gorges region, and this paper also provides some suggestions for improving MSWM in the Three Gorges region.