Many big cities in Indonesia are suffering from severe problem caused by disorderly Municipal Solid Waste (MSW) handling. This paper will highlight the main issues of MSW management in Indonesia such as technical, institutional, financial, environmental and social aspects. To effectively and efficiently overcome this problem, a holistic approach to develop solutions is required. The general method currently practiced in MSW management all over Indonesia is collect-transport-dispose. The authority of urban municipalities is transporting the MSW from designated collection point to a location for its final dumping. Most of the local authorities practice crude open dumping, creating a despondent situation at the landfill sites. Most of municipalities have no other alternative if their existing landfill are in a trouble state, and have no experience in another better and more continuous way of handling waste. In so far, the existing landfills are not adequately prepared and are not well and professionally operated to the extent that landfill trouble cases would always appear. Leuwigajah landfill failure case in Bandung in 2005 forced the entire stakeholders, including the central and local governments, to recognize the urgency of improving or changing the existing waste management paradigm. In May 7, 2008 the Solid Waste Management Act 18/2008 was announced. This act is expected to bring major changes, and new challenges in waste management, which will serve as umbrella for sound municipal solid waste managements in Indonesia.