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In Pakistan, thousands of small clinics generate distributed medical waste; nevertheless, unlike large hospitals, small clinic waste management is frequently neglected. This study was conducted on 35 small clinics in Karachi, Pakistan, with the objective of determining small clinics' waste management practises in comparison to level of knowledge. Overall, the rate of waste production was assessed to be 1.87 kg/clinic/day, while the rate of hazardous waste production was 0.68 kg/clinic/day and the rate of general waste production was 1.19 kg/clinic/day. The waste management practises of the assessed clinics were dismal; none of the clinics were fully adhering to the 2005 hospital waste management guidelines, and so improper segregation, storage, transportation, and disposal were frequently seen over the course of the study. The clinic employees held a low level of knowledge and awareness and received no training on waste management practises and regulations. Furthermore, there was a high rate of employee turnover. As a result, it was determined that active government involvement and financial support in giving training and auditing small clinics could contribute to the improvement of the condition. The present study's findings can play an important role in documenting evidence and assisting policymakers and governments in planning solid waste management for small clinics and other healthcare institutions.