Medical waste management in the modern healthcare era: A comprehensive review of technologies, environmental impact, and sustainable practices

• COVID-19 increased medical waste to 29,000 tonnes/day, straining global systems. • Plasma treatment achieves 90–97 % waste reduction with 78.61 % cold gas efficiency. • Blockchain tracking reduces waste mishandling by 30 % and improves cost efficiency. • Circular economy integration achieves 65 % material recovery, reducing disposal costs. This comprehensive review addresses critical challenges in modern medical waste management, a concern significantly heightened by the COVID-19 pandemic. Our work uniquely synthesizes and critically assesses emerging technologies, their economic feasibility, and sustainability frameworks within a post-COVID-19 context. The analysis reveals that while conventional incineration remains a dominant practice (60–75 % of global medical waste), it carries considerable environmental risks. In contrast, emerging solutions like plasma gasification and advanced pyrolysis are promising, but face significant implementation barriers. While plasma systems achieve a 90–97 % waste volume reduction and over 99.99 % pathogen elimination, and pyrolysis efficiently converts plastic waste into valuable fuels (35–50 wt% liquid oil), their high capital costs and operational complexities require careful consideration. The COVID-19 pandemic exacerbated waste pressures, increasing global medical waste production by an estimated 3.4 kg per bed per day, with surges up to 425 % in developing nations. We identify significant disparities in management, as many low-income countries face substantial infrastructure and resource challenges that hinder the adoption of these advanced technologies. This work concludes with a critical roadmap for future research and policy, emphasizing the need for robust technical innovations and harmonized international standards to foster more sustainable and pragmatic practices.