This study aimed to evaluate the reality of medical waste management at Al-Zahra General Hospital through five main dimensions: knowledge and awareness, procedures and mechanisms, occupational safety and prevention, transportation and treatment, and compliance with regulations and legislation. The study adopted a descriptive-analytical approach using a questionnaire distributed to a sample of hospital staff, and the data were analyzed statistically. The results revealed that workers possess a good level of theoretical knowledge regarding hazardous and non-hazardous medical waste (mean = 3.55). However, practical training, workshops, and instructional manuals did not reach the required level (mean = 3.0), reflecting a clear gap between theoretical knowledge and practical application. The findings also indicated deficiencies in the segregation of medical waste from general waste, as well as the absence of guiding signs and effective emergency plans, with results in this dimension being low (mean = 2.83–2.9). In terms of occupational safety and prevention, personal protective equipment was adequately available (mean = 3.42), and management showed interest in conducting periodic medical examinations for staff (mean = 3.4–3.5). Nevertheless, practical measures to reduce infection remained weak (mean = 3.2). The transportation and treatment dimension was the weakest, as results showed the absence of primary treatment for hazardous waste, and the lack of incinerators or integrated treatment units, with all items scoring low (mean = 2.6–2.9). Regarding compliance with regulations and legislation, adherence was found to be superficial and neutral (mean = 2.78), due to the absence of strict administrative monitoring. The study concluded that the hospital has a solid foundation in knowledge and prevention, but suffers from significant weaknesses in practical training, segregation mechanisms, transportation and treatment, and actual compliance with legislation. It recommended strengthening continuous training and awareness programs, improving segregation and documentation procedures, developing infrastructure for waste treatment or contracting licensed companies, and activating internal monitoring to ensure safe, effective, and environmentally friendly medical waste managemen Keywords: Medical Waste , Healthcare Waste Management (HCWM) Occupational Safety, Waste Segregation and Treatment, Environmental and Health Awareness, Infection Control.