Municipal Solid Waste Management (MSWM) affects several spheres, including environmental, social, and economic activities. In Ethiopia, massive waste generation and unbalanced management have worsened the issue. Hence, this systematic review investigates the Ethiopian MSWM policy and legal frameworks, practices, and challenges. The Scopus and Web of Science databases and Google Scholar were used to search published and unpublished studies from 2005 to 2021, and a website search was used to find studies from 1995 to 2021. The search was restricted to the English language, and the last search was conducted on 25 June 2021. The study was extracted from the characteristics of the developed study. A risk of bias assessment was conducted for the included studies using the AMSTAR 2. Among the 1135 identified records, 72 studies were found to be eligible. This systematic review identified numerous legal frameworks that enhance the implementation of MSWM in Ethiopia, which is mainly focused on waste collection, transportation, and disposal. Lack of policy enforcement, weak capacity, public awareness, and minimal cooperation among stakeholders were the main challenges. MSWM problems in Ethiopia have seen an increase in recent decades and are affecting daily life. Therefore, these findings may help to improve MSWM in Ethiopia.