A sustainable waste management policy is necessary to manage the growing stream of municipal solid waste in ecologically sustainable ways. Although landfill has been the dominant form of waste management in the UK there is a need to comply with the European Union landfill directive. Waste to energy (WtE) is a viable waste management option to reduce the reliance on landfills and reap the energy benefits of waste. The first waste-fired power plant was built in the UK in 1885 but several barriers have constrained the use of WtE. This paper assesses the policy and institutional context for the development of WtE in the UK. It discusses how public opinion and choice of technology are important factors in achieving a wider acceptance of WtE in the UK. There is a need to devise coordinated policies on sustainable waste management at the regional and local levels. Furthermore, making all WtE technologies eligible for renewable obligation certificates could support the development of the technology and divert waste from landfills. The absence of efficient heat delivery networks is also a barrier to fulfilling the potential for WtE in the UK.