The study attempts to develop a methodology for comparing hospital solid waste handling systems from a point of view which considers both the operational and the social costs. The problem is laid out as a decision tree, where nodes of the tree represent decision points at stages of hospital waste handling, and branches at any node represent the different systems available at that point. Cost functions are developed for each alternative, with hospital characteristics and performance standards as parameters in the functions. The optimal system minimizes the total cost of collection, treatment and transportation to the point of final disposal, while maintaining the prescribed performance standards. A model of a centralized incineration system, which combines the waste hauling and treatment systems of hospitals in an area, is developed and applied to hospitals in the Minneapolis and St. Paul metropolitan area. (Modified author abstract)