Background: Biomedical waste management problem in healthcare establishments (HCE) has become an issue of growing concern globally. Further the problem is aggravated due to the marked increase in disposable health-care materials. Improper healthcare waste management may have serious health consequences and a significant impact on the environment as well. Methods: A cross-sectional and observational study was conducted during June 2017 to August 2018 among the Health care establishments in Karimnagar city. A total of 234 health care centers present in the city, 58 health-care centers were taken up for the study. For descriptive purpose, the 58 health-care centers were grouped in five different groups (i.e., group 1 to group 5). Data was collected from both the health care workers and hospital administration by using preformed questionnaire and was analyzed using SPSS 24 and valid inferences were drawn. Results: The overall management of category yellow waste was not done properly in many groups of health centers except group 1(government hospitals), group 2 (private medical college teaching hospitals) and few health-care centers in group 3 and group-5 and over all segregation of category white waste was 26(45.5%). The Segregation of category of red waste was observed in 20 (34%) in the current study. Conclusion: The present study demonstrates that there has been an improper procedure of medical waste management in Karimnagar city. No HCE segregated their generated wastes, except medical college teaching hospital and few private specialty hospitals. In some HCE, they used to segregate their sharps and infectious wastes in separate bins and send off them to the Venkataramana incinerators (CBWTF), Karimnagar for the final disposal waste.