Sustainable waste management is a very important issue that has received increasing attention in recent years due to its significant impact on the environment and human health. As the population and urbanization increase, more and more waste is generated, leading to problems such as pollution, resource depletion, climate change, etc. Therefore, it is necessary to develop effective waste management strategies that are sustainable and do not harm the environment. The EU is making progress in sustainable waste management within the wider context of a circular economy, but challenges remain, particularly in reducing material consumption and effectively managing specific waste streams. The EU’s approach involves setting clear targets, monitoring progress in a comprehensive framework, and supporting Member States in achieving these targets. In 2019, Lithuanian companies invested about 40% more in environmental protection than in 2018. Notably, 15% of them are invested in waste management. An inhabitant throws out an average of 278 kilograms of mixed municipal waste per year. According to the global waste index in 2022, Lithuania ranked 16th (up from 23rd place), Latvia 37th (down from 35th place), and Estonia 32nd (down from 30th place). The purpose of this article is to identify the factors that determine sustainable waste management in cities and to predict the changes that will occur. Research methods: synthesis and comparison of concepts and methods in scientific literature, secondary data analysis, statistical data processing, and expert interview methods. Research results: It has been determined which factors and how they determine sustainable waste management in the country. The experts evaluated the alternatives—waste prevention, reuse, recycling, and optimization of landfills—according to the following criteria: economic, social, environmental protection, and technology. The most important criterion was determined to be the environmental protection criterion.