The management of solid waste is integral to city sanitation. Over the last decade, larger cities, especially those with financial and managerial capacity, have attempted to improve waste management practices in response to the Municipal Solid Waste (MSW) Rules 2000. In this, the development of disposal infrastructure, i.e., sanitary landfills, has made the least progress due to factors ranging from land scarcity to lack of technical and financial capacity in cities. These challenges are further accentuated in smaller Urban Local Bodies (ULBs). The objective of this Guidance Note is to identify and address issues in the implementation of regional arrangements for delivery of MSW management services. While some of these are common to all MSW management initiatives, there are specific issues that need to be addressed in the context of regional arrangements. By focusing on these, it is hoped to facilitate the establishment of regional initiatives to enhance compliance with the MSW Rules 2000.