Municipal Solid Waste Management (MSWM) remains a crucial environmental and public health concern in most of the fastest urbanizing areas, even in Nepal. An exploration of public opinion and economic feasibility of MSWM using sustainable strategies in Gaindakot Municipality, an expanding urban municipality of the Nawalparasi (East) District, is carried out. Employing a mixed-methods study design that comprises household surveys, interviews with stakeholders, field observation, and qualitative waste composition analysis, the current study presents an integrated analysis of the waste management system in the municipality. The findings indicate that despite 82% of the residents citing solid waste as the major problem, organized waste management practices are not consistently followed. Although 65% of the households utilize the municipal waste collection service, 16% still follow hazardous practices such as open dumping. This behavior pattern is also sustained by infrastructural deficits, such as the absence of engineered landfill facilities and composting facilities. Field surveys indicate that the city generates approximately 16.14 metric tons of waste daily, of which more than 60% is organic in composition, representing a gigantic potential for composting as well as energy production. The estimated daily revenue from recyclable waste material is NPR 63,760, i.e., it is economically worth implementing a circular model of waste management. There are, however, institutional problems like an absent master plan for integrated waste management, no technical capacity, and poor coordination among the stakeholders. In order to fill these ambiguities, the study makes the following practical suggestions: implementation of source segregation, facilitation of public-private partnerships, provision of economic incentives, and institutional capacity building through tailor-made training and policy support. The research provides policymakers, planners, and development agencies critical findings centered on the necessity for a socially inclusive, economically feasible, and environmentally sound MSWM system responsive to the condition of secondary cities in the Global South.