Municipal solid waste management (MSWM) is an important, practical and challenging environmental subject. The processes of a MSWM system include household collection, transportation, treatment, material recycling, compost and disposal. A regional program of MSWM is more complicated owing to the involvement of multi-municipality and multi-facility issues. Therefore, an effective decision support system capable of solving regional MSWM problems is necessary for decision-makers. This article employs linear programming techniques to establish a MSWM decision support system (MSWM-DSS) that is able to determine the least costs of regional MSWM strategies. The results of investigating a real-world case in central Taiwan indicate that a regional program is more economical and efficient. For the redeployment of MSW streams, the relatively least cost of operation for the MSWM system can still be achieved through the re-estimation of the MSWM-DSS. This tool and results are useful for MSWM policy-making in central Taiwan.