In the Campania region, an area in the south of Italy with 5.7 million inhabitants and a production of about 7,900 tonnes of municipal solid waste per day, an emergency situation was created by inappropriate waste management policy and practice. In order to support decisions regarding future solutions for this crisis, reliable, transparent, and impartial strategies and concepts are needed. For this purpose, six waste management scenarios have been defined and quantitatively assessed by means of substance flow analysis (SFA). The scenarios are based on firm objectives and recent legislation for waste management and take into account regional waste production and composition as well as existing waste treatment infrastructure. They are evaluated and compared with the status quo in view of reaching the goals of waste management. For each scenario, the following material flows were quantified: wastes that would be sent to different processes, such as those of mechanical‐biological treatment, incineration, or anaerobic digestion; treatment residues (in mass and volume) to be diverted to landfills; materials recoverable by recycling processes; and energy obtainable by waste‐to‐energy and anaerobic digestion plants. The results demonstrate that a future waste management system that is based on a combination of more recycling, thermal treatment, anaerobic digestion, and improved landfilling reaches the objectives of waste management much more closely than the present, inadequate system.