Healthcare waste has been managed anyhow in the past mainly to avoid its stockpile, nuisance and public reaction without much concern to public health and the environment. Two waste categories are considered: general and hazardous. The former is not infectious. The latter contains infectious, chemical or radioactive properties and needs to be managed properly. This study within 5 healthcare facilities within the Accra and Tema Metropolitan areas in Ghana focused on the practice from generation to disposal, a review of the draft national guidelines on Healthcare waste, roles of other government agencies and the adoption of appropriate management options. HCW was not well managed. The system lacked the necessary safety measures. Treatment and disposal methods within and outside the healthcare premises were not satisfactory. A national law to promote, monitor standards and address issues of non-compliance was lacking. An integrated management system is required. The analysis has highlighted gaps and the way forward for handling healthcare waste in developing countries and should also benefit academicians and professionals in waste management, public health and environmental science.