In most developing countries it is the urban authorities that are responsible for waste management. Waste management is one of the most visible urban services whose effectiveness and sustainability serves as an indicator for good local governance, sound municipal management and successful urban reforms. Waste management, therefore, is a very good indicator of the performance of a municipality. Information for the preparation of this chapter came entirely from publications and reports on waste management in Urban Councils of the East African Community (EAC) Countries of Kenya, Tanzania and Uganda. The chapter examines the management of solid waste from the source to final disposal and will describe and compare waste management in East African cities. It also considers E-waste which is becoming a significant management issue in East African urban centres.