Efficient municipal waste management is one of the key aspects of smart cities. In the literature, modern technological solutions are mainly analyzed in this context on the example of specific case studies. However, the author of this article attempts a more fundamental, holistic and comparative assessment of waste management in cities, recognized as smart and aspiring to this title. The objective of this attempt is to answer the following question: What results do the designated cities achieve in terms of waste volume reduction, waste segregation and collection costs? The research was carried out on 16 Polish provincial cities used as examples, including two (Warsaw and Wrocław) classified as smart cities in ranking of the Cities in Motion Index 2020. The analysis period covers 2019–2021, and during the research, in addition to the parameters listed above, a multi-criteria analysis was used to allow a collective assessment of the effectiveness of municipal management in the surveyed cities. The results obtained allow the conclusion that the volume of waste per capita in most of the analyzed cities is steadily increasing. The cost of waste management is also growing significantly. These unfavorable phenomena are particularly acute for smart cities, which in the holistic assessment were ranked among the three least effective units in terms of waste management (Lublin, Warsaw, Wrocław).