The study analyzes the failures of municipal solid waste management systems in the Sudano-Sahelian cities of Cameroon (Maroua, Garoua, and Kousséri) and assesses their environmental impacts. By combining quantitative and qualitative approaches, we demonstrate that the lack of adequate infrastructure, insufficient community awareness, and the inadequacy of effective public policies contribute to adverse consequences for public health, as well as for soil quality, air quality, and water resources. The findings reveal a strong correlation between systemic management dysfunctions and the uncontrolled accumulation of waste, thereby promoting pollution, the spread of diseases, and ecosystem degradation. Based on a comparative diagnostic assessment, practical recommendations are proposed to strengthen local waste management structures, promote circular economy principles, and implement integrated waste management policies.