Mitigating greenhouse gas (GHG) emissions is vital for creating sustainable municipal solid waste management systems (MSWMS). In this study, we constructed an MSWMS considering recycling and carried out GHG emission accounting for MSWMS in western China from 2012 to 2021 based on the IPCC mass balance (MB) method. Then, we modeled the emission reduction potentials and economic benefits under different scenarios for 211 prefectural and county-level cities. We formed an eco-efficiency analysis framework that can be used to explore the sustainable development mode. Results revealed that: (1) Emissions from the western region's municipal solid waste (MSW) disposal exhibit an inverted “U” pattern, increasing at an annual rate of about 1.3 % since 2012, peaking in 2019, and then decreasing at rates of 14.4 % and 10.6 %. (2) The GHG emissions show a spatial pattern of decreasing evolution from east to west and south to north, and the provincial-municipal level shows different trends. (3) The SB3 scenario (optimization of landfill gas power generation technology) was the most ecologically efficient in 43 % of the western cities, followed by SB4 (33 %) and SA3 (24 %). (4) The development of integrated urban domestic waste management strategies by the three-level scenarios derived from this study will help local governments achieve the goal of sustainable urban development. Clarifying the differences in GHG emissions and eco-efficiency among cities will help provide policy recommendations for regions with similar characteristics to explore technically applicable, economically affordable implementation paths for city management according to local conditions.