With rapid urbanization, population growth, and new economic activity, municipal solid waste is increasing at alarming rates, and is expected to almost triple in low and lower middle income countries by 2025. At the same time, solid waste management (SWM) systems in most developing countries are underfunded and suffer from a lack of planning. Improving SWM requires intervention all along the supply chain. Such improvements do not necessarily require major financial investment. Low-cost interventions that utilize existing technical and human resources, combined with support for crucial behavior changes at individual and municipal level, can bring about significant enhancements in SWM. Output-based aid (OBA) is a results-based financing mechanism that ties the disbursement of funds to the achievement of specified outputs. This note examines the design of two projects—in Nepal and the West Bank—that use an OBA approach to SWM.