Abstract: After the outbreak of the COVID-19， China had made up for the shortcomings of medical waste. Small medical institutions had become the weak link in the standardized management of medical waste. It was of great significance to crack the “last kilometer” of medical waste collection and transportation in small medical institutions. Through the analysis of the implementation background， implementation basis， operation effect and operation benefit of the “last kilometer” of medical waste in small medical institutions in Shanghai， a comprehensive and in-depth study of the practice in Shanghai had been conducted. The results showed that after the implementation of the model， the frequency of medical waste collection and transportation in small medical institutions in the city had been significantly improved， the process was relatively standardized， and the transportation capacity had been effectively improved. It had better environmental and social benefits， the “last kilometer” of medical waste collection and transportation in small medical institutions in Shanghai had been made up， and the level of urban refined governance and the ability to guarantee public health security were improved.

Key words: small medical institutions, medical waste, collection and transportation, last kilometer