Patient care in hospitals and other healthcare facilities necessarily generate wastes which are hazardous and infectious. If not manged properly it poses grave hazard to human health, and the environment. Legislative measures in India were enunciated in 1998 and rules were promulgated.Segregation of waste at source is the most important step in the management of hospital waste. All the countries where hospital waste management is in vogue have categorized the hospital waste, and segregation is required to be in accordance with the categories. But categories also create confusion and add to the cost of waste management. Therefore another way to segregate the waste could be by intended terminal treatment option. This way the waste handlers may be clear as to which type of waste is to be put in which container.Safety measures and risk management is even more important in hospital environment.This aspect has been discussed. Training and awareness should be regular and periodic which has been suggested with training modules.Proper healthcare waste management in India remains deficient in implementation. Reasons are discussed with steps for improvement.