The aim of the study was to analyze the performance of large scale incinerator installed in a referral hospital. The study involved weighing and loading infectious waste of different composition (sharps and other waste), recording temperatures in the primary and secondary chamber with time, fuel used and collecting and weighing the bottom ash for 65 days. The analysis shows that the incinerator on average uses 362 L/day (45 L/h) to incinerate 945 kg of medical waste (40.8 kg/day of sharps waste and 904 kg/day of other waste), generating 51.2 kg of ash daily. The observed fuel consumption rate was too high necessitating corrective action. The average weight reduction was 94.6%. The study shows that the average sharps waste composition for medical waste incinerated was 4.3% and other waste was 95.7%. The incinerator capacity ranged between 100 and 130 kg/h. The fuel effectiveness ranged between 2.0 and 3.0 liters of diesel per kg of waste incinerated. The fuel effectiveness increased linearly with total waste incinerated and incinerator capacity, respectively, depending on the fuel consumption rate.