The predominant management approach for municipal solid waste (MSW) remains disposal, given significant increases in generation and disposal rates of MSW in recent decades. In addition to the well-documented carbon emissions from disposal sites, these sites accumulate numerous elements, the masses of which are substantial globally yet inadequately quantified. The unique combinations of waste constituents, elements, diverse environments, and confined spaces in disposal sites create distinct biogeochemical conditions, setting them apart from any other infrastructure or geological feature on Earth. This review first presents a global summary of the cumulative masses and disposal rates of MSW constituents and associated elements. The five dominant transformation and transport processes influencing disposed elements are examined: biochemical degradation, physicochemical transformation, gas migration, leachate migration, and solid spillage. The magnitudes and rates of the processes corresponding to major disposed elements, including carbon, nitrogen, sulfur, chlorine, and several metals, are systematically summarized. We examine and quantify the potential environmental impacts and health risks associated with element transformation and transport. We also explore the existing knowledge and techniques for resource recovery and site remediation of disposal sites. The distilled compilation of measurements and insights herein serves as a valuable primer for researchers, practitioners, and decision-makers involved in MSW management.