This study develops a sustainability assessment model for analysis and decision-making of the impact of China's municipal solid waste management enhancement strategy options based on three waste treatment scenarios: landfill disposal, waste-to-energy incineration, and a combination of a material recovery facility and composting. The model employs life cycle assessment, health risk assessment, and full cost accounting to evaluate the treatment scenarios regarding safeguarding public health, protecting the environment and conserving resources, and economic feasibility. The model then uses an analytic hierarchy process for an overall appraisal of sustainability. Results suggest that a combination of material recovery and composting is the most efficient option. The study results clarify sustainable attributes, suitable predications, evaluation modeling, and stakeholder involvement issues in solid waste management. The demonstration of the use of sustainability assessment model (SAM) provides flexibility by allowing assessment for a municipal solid waste management (MSWM) strategy on a case-by-case basis, taking into account site-specific factors, therefore it has the potential for flexible applications in different communities/regions.