In Peru, socio-environmental conflicts related to the development of mining-metallurgical processes and the responsible disposal of mine tailings have become central issues for accepting mining projects, especially regarding building relationships of trust with the communities. This condition has prompted the Peruvian mining industry to advance in managing alternatives to the conventional surface disposal of mine tailings. A promising and increasingly popular management strategy for mine tailings in Peru is their disposal inside underground mines. This article presents: site-specific conditions, advantages/disadvantages, and lessons learned from practical experiences of mine tailings disposal in underground mines in Peru. In addition, some techniques are highlighted, such as (i) hydraulic fill, (ii) cemented hydraulic fill, and (iii) cemented paste backfill. Finally, this article concludes that the responsible disposal of mine tailings in underground mines is a green mining solution that reduces negative socio-environmental impacts, limiting the generation of acid rock drainage (ARD) and the leaching of metals due to the decrease in contact with oxygen and rainfall, thus mitigating the contamination of surface and underground waters, reducing the footprint of affectation in the territory, and eliminating the emission of particulate matter in the environment.