Hospital waste management is a major public health concern. This study analyzes the classification practices of hospital waste in the health facilities of Lubao Territory, Democratic Republic of Congo, assessing compliance with national and international standards, and identifying key challenges. Using a mixed-methods approach—surveys, direct observation, and interviews—the study finds that classification practices are often empirical and poorly aligned with regulatory standards. Key issues include lack of training, inadequate equipment, and absence of monitoring mechanisms. Recommendations are offered to improve environmental governance in healthcare facilities.