Background The management of medical waste is a complex task that necessitates effective strategies to mitigate health risks, comply with regulations, and minimize environmental impact. In this study, a novel approach based on collaboration and technological advancements is proposed. Methods By utilizing colored bags with identification tags, smart containers with sensors, object recognition sensors, air and soil control sensors, vehicles with Global Positioning System (GPS) and temperature humidity sensors, and outsourced waste treatment, the system optimizes waste sorting, storage, and treatment operations. Additionally, the incorporation of explainable artificial intelligence (XAI) technology, leveraging scikit-learn, xgboost, catboost, lightgbm, and skorch, provides real-time insights and data analytics, facilitating informed decision-making and process optimization. Results The integration of these cutting-edge technologies forms the foundation of an efficient and intelligent medical waste management system. Furthermore, the article highlights the use of genetic algorithms (GA) to solve vehicle routing models, optimizing waste collection routes and minimizing transportation time to treatment centers. Conclusions Overall, the combination of advanced technologies, optimization algorithms, and XAI contributes to improved waste management practices, ultimately benefiting both public health and the environment.