Disposal of municipal solid waste (MSW) is an important environmental and hygienic problem, but it causes not only environmental, but also great economic damage. From January 1, 2019, it was planned to carry out a reform of solid waste management. Many regions were not ready for waste reform. The problem of waste disposal is especially acute in federal cities. The goal is to study the readiness of regional operators in large cities (Moscow, St. Petersburg, Sevastopol) and students to solve the problem of waste disposal. A total of 100 solid waste collection sites were examined in the central and peripheral regions of Moscow, St. Petersburg and Sevastopol. An online survey of 356 medical students was conducted. When examining districts of three cities, the main difficulties in the peripheral regions were insufficient lighting, lack of fences and protective soil coverings, in the central regions - non-compliance with zoning in the location of sites in relation to the housing stock, lack of lids on containers, which worsens the sanitary and epidemiological situation. The main motivations for students to participate in separate waste collection were the convenience of container location and incentives; environmental problems were of interest to only 4% of respondents. The results of the study revealed the need to continue reforming the primary level of solid waste management and conducting environmental and hygienic education of the population, including youth and students, in terms of the importance of waste management using modern technologies.