Management of medical wastes generated at different hospitals in Egypt is considered a highly serious problem. The sources and quantities of regulated medical wastes have been thoroughly surveyed and estimated (75 t/day from governmental hospitals in Cairo). From the collected data it was concluded that the most appropriate incinerator capacity is 150 kg/h. The objective of this work is to develop the process engineering design of an integrated unit, which is technically and economically capable for incinerating medical wastes and treatment of combustion gases. Such unit consists of (i) an incineration unit (INC-1) having an operating temperature of 1100 degrees C at 300% excess air, (ii) combustion-gases cooler (HE-1) generating 35 m(3) /h hot water at 75 degrees C, (iii) dust filter (DF- 1) capable of reducing particulates to 10-20mg/Nm(3), (iv) gas scrubbers (GS-1,2) for removing acidic gases, (v) a multi-tube fixed bed catalytic converter (CC- 1) to maintain the level of dioxins and furans below 0. 1 ng/Nm(3), and (vi) an induced-draft suction fan system (SF- 1) that can handle 6500 Nm(3)/h at 250 degrees C. The residence time of combustion gases in the ignition, mixing and combustion chambers was found to be 2 s, 0.25 s and 0.75 s, respectively. This will ensure both thorough homogenization of combustion gases and complete destruction of harmful constituents of the refuse. The adequate engineering design of individual process equipment results in competitive fixed and operating investments. The incineration unit has proved its high operating efficiency through the measurements of different pollutant-levels vented to the open atmosphere, which was found to be in conformity with the maximum allowable limits as specified in the law number 4/1994 issued by the Egyptian Environmental Affairs Agency (EEAA) and the European standards. (c) 2006 Elsevier B.V. All rights reserved.