Ho Chi Minh City is a large city that will become a mega-city in the near future. The city struggles with a rapidly increasing flow of municipal solid waste and a foreseeable scarcity of land to continue landfilling, the main treatment of municipal solid waste up to now. Therefore, additional municipal solid waste treatment technologies are needed. The objective of this article is to support decision-making towards more sustainable and cost-effective municipal solid waste strategies in developing countries, in particular Vietnam. A quantitative decision support model is developed to optimise the distribution of municipal solid waste from population areas to treatment plants, the treatment technologies and their capacities for the near future given available infrastructure and cost factors.