Health-care waste (HCW) management is a high priority environmental, public and health concern in developing countries. The management and treatment of HCW are gaining more attention with the rising awareness. The objective of this research is to propose multi-criteria decision making techniques for conducting an analysis based on multi-level hierarchical structure and fuzzy logic for the evaluation of HCW treatment alternatives. The ideal and anti-ideal solutions are taken into consideration simultaneously in the developed approaches to account for the individuals' desire to be both as close as possible to the ideal and as distant as possible from the anti-ideal. The proposed decision approaches enable the decision-makers to use linguistic terms, and thus, reduce their cognitive burden in the evaluation process. Furthermore, a hierarchy of evaluation criteria and their related sub-criteria is employed in the presented approaches in order to conduct a more effective analysis. The computational procedures of the proposed frameworks are illustrated through a case study in Istanbul, the largest city of Turkey that is also listed among the world's most crowded cities. The HCW treatment alternatives considered in this study include "incineration", "steam sterilization", "microwave" and "landfill". The results obtained using the proposed decision approaches are analyzed in a comparative way. (C) 2011 Elsevier B.V. All rights reserved.