Solid waste generation is attested to be unavoidable product of human activities. Sustainable management of such waste is a pressing challenge faced in many developing countries today. The study was motivated by the fast growing population and the inefficient waste management system threatening the public health and the image of Shashemene city in Ethiopia. The objectives of the study were: to explore the existing household solid waste management practices, to examine the current governance system of municipal solid waste management, to investigate the contemporary challenges and opportunities of municipal solid waste management, and forward integrated and sustainable municipal solid waste management system for Shashemene city. Data were collected from sampled households, key informants, focus groups, and the city's environment. Data were analyzed by employing quantitative and qualitative methods. 94.8 % of the respondents opined that the solid waste generated in their city is organic in nature (Ash, and sweeps; leftover food, and vegetable peels; paper, and cardboards; green leaves, and grass; and cattle dung). 96.7 % of respondent households opined that they have temporary waste storage in their yards and trash bags were asserted to be widely used (87.6 %) in handling the trash in the courtyard. The waste sorting and recovering practices among the residents is very low and is certainly the major cause for inefficient and unsustainable management system of municipal solid waste in Shashemene city. Generally, a grand mean of 2.23 confirmed the absence of good governance in municipal solid waste management system in Shashemene city. Moreover, the significant proportion of responses ( ≥ 50 %) for each of the nine principles of good governance as either poor or very poor asserted governance failure of the municipal solid waste management system in Shashemene city. The results of the study confirmed that low public awareness on waste management; inadequate collection capacity; poor integration and coordination of stakeholders; environmentally unsound dump site; and illegal dumping by key stakeholders are the major challenges underpinning the unsustainable municipal solid waste management in the city. It is recommended that Shashemene city must adopt integrated sustainable municipal solid waste management system to substantially enhance the waste management service in the city leading to ultimate advancement of public health and environmental quality.