Considerations of ecology, public health hazards, and rising health costs have been critically reevaluated in the matter of appropriate medical waste disposal at nursing homes and hospitals. The Maryland Department of Health has intermittently received reports from the public of human tissues, bandages, and other inappropriate, unaesthetic materials visible in landfill areas. The Department has experienced increasing concern for communicable disease transmission, e.g. hepatitis, to landfill waste handlers and to the general public. Incineration had been considered as an alternative to landfilling of medical wastes, but fear of increasing hospital costs dampened initial enthusiasm for this possibility, particularly when coupled with fears of air pollution by smoke and noxious fumes generated by incineration. Other problems requiring resolution were conflicting definitions of medical waste and disposal requirements by federal, state, and local regulatory bodies. On-site incineration of all waste generated at hospitals is proposed as an economical and ecologically feasible solution to this public health problem in Maryland.