Municipal solid waste management (MSWM) in Indonesia is increasingly complex for various reasons. The quantity of solid waste is expected to increase substantially due to an increasing population and rapid urbanization. Each municipality in Indonesia has a distinct technique and method to manage solid waste, depending on the peculiarities and problems. Cities and regencies have different characteristics. Research on municipal solid waste management conducted in regency areas is still limited. This study aims to investigate the implementation of MSWM in Indonesian regency areas. This study is based on a literature review and the relevant policies, but it also incorporates simple statistical analysis to support the points and arguments in this paper. The review found differences characteristic of MSWM in regency areas and city areas, such as waste generation, waste composition, and source of waste. MSWM solutions vary according to each municipality and rely heavily on local governments’ commitment and their financial, technical, and institutional capacity. The existing waste problem must be addressed holistically from upstream to downstream with a ‘cradle-to-grave’ mindset to create tangible advances in Indonesia’s solid waste management.