A rapid growth of population in Dakar has led to an increase in the number of healthcare facilities in the city, with an immediate consequence of considerable increase in biomedical waste generation and considerable challenge to the already burdened the city’s waste management system. Building on the special treatment required for biomedical wastes (BMW) due to associated health and environmental risks, this paper examines the historic evolution of legal framework for biomedical wastes management and related health and environmental issues in Dakar, Senegal. Historically, the country has ratified many international treaties, including Basle, Stockholm, and Bamako Conventions; however the paper demonstrates a lack of an efficient chain for biomedical wastes disposal in Dakar. Building on evidence from literature and the most recent qualitative and quantitative study of the city, the major barriers identified for the poor state of affairs is attributed mainly to lack of financial resources and weak law enforcement. This is not only in relation to BMW but solid waste management in general. Therefore, significant investment for an effective and proper BMW management in Dakar is of paramount importance in order to address environmental contamination, human exposure and associated loss to health. However, the same holds true for SWM generally in the city.