The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Inadequate and inappropriate knowledge and practice of handling of healthcare waste may have serious health consequences and significant impact on the environment therefore the investigators conduct a survey study to assess the knowledge and practices of Safai Karmachari regarding biomedical waste management. Investigators adopted the descriptive co-relational design where 30 Safai Karmachari were selected by non-probability convenient sampling technique at CRH, Gangtok. Validated structured interview schedule and observational checklist were used to collect data. The findings of the study reveals that knowledge regarding the meaning (96.6%), storage (45%) and 71.6% on disposal/treatment of bio medical waste management was found to be better. Regarding practices, segregation was practiced by 16.67% whereas (93.33%) practiced transportation and there was a significant association between practice and years of experience as seen by χ2 value (p < 0.05). The importance of training regarding biomedical waste management needs emphasis, lack of proper and complete knowledge about biomedical waste management impacts practices of appropriate waste segregation.