Conventional wisdom views municipal solid waste management (MSWM) as the responsibility of government or city authorities in Ghana and many African countries with urbanites (i.e. urban residents) always calling on government to deliver them from the problem. Overwhelmed with the scale of the problem, city authorities frequently seek public-private partnerships with firms (both local and international) to address the problem. While city authorities' efforts maybe praiseworthy, the problem seems intractable. Using a case study from Berekum municipality in Ghana, this paper demonstrates how a lack of attention to the role of urbanites in MSWM has contributed to poor state of solid waste management (SWM). It presents a situational analysis of MSWM, and perceptions and roles of urbanites in the MSWM. Using agency interviews and household surveys, findings indicate that the state of MSWM reflects the indescribable condition of filth across many African countries. Although household respondents expressed willingness to actively participate in MSWM (e.g., provision of logistics, supervision of SWM activities etc.), they are not involved by the government agencies who consider MSWM as government's responsibility. Unfortunately, the political economy of awarding SWM contracts to political party supporters and financiers have contributed to poor SWM. As a consequence, some households are gradually becoming apathetic to MSWM issues due to their non-involvement. Policy recommendations to improve MSWM are proffered.