Pollution of the environment and inappropriate management of medical wastes are major challenges facing developing countries and this must be tackled with recent technology for public health, enhanced natural ecosystems, and a better environment. This research is a two-step process that involves the assessment of the existing Hospital waste management practices in a multi-system Hospital in Ado-Ekiti, Nigeria. Excess air, kerosene (auxiliary fuel), single chamber, Batch-fed (Manual feeding), and controlled air incinerator were designed. Wastes were loaded once at the beginning of the combustion cycle followed by combustion, ash burnout, cool down, and ash removal to assist medical waste management. Findings revealed that personnel involved in handling medical waste were equipped with inadequate protective gear. Medical waste was handled together with municipal waste and both wastes were incinerated in an open dumpsite without engineered sanitary landfill at disposal locations constituting a nuisance with a high risk of pollution to the surrounding environment. The incinerator was designed for a waste load of 269 kg.day-1. It consists of four zones; the waste and combustion zone (2.7 m × 1.8 m × 1 m), the ash zone (0.23 m height), the combustion fumes and one-second retention zone (0.43 m height) as well as the excess air zone (0.46 m height). This low-cost medical waste incinerator has a lot of improvement, operational effectiveness, and efficiency to the currently available techniques. Viable recommendations made will improve the state of environmental health and reduce the harmful effects of medical waste.