Objective To evaluate the efficacy of refined supervision measures on standardizing medical waste management. Methods Five wards of a tertiary hospital were selected to implement refined supervision measures, including special training and checking on medical waste classification knowledge, pasting graphic signs, on-site inspecting classification as well as on-site feedback and guidance. The baseline survey period was from March to May 2019, intervention period was from November 2020 to January 2021, health care workers' knowledge on medical waste classification, classification accuracy as well as changes in weight of medical waste before and after intervention were compared. Results After the implementation of refined supervision measures, the qualified rate of check of health care workers in medical waste classification knowledge (>60 points) increased from 51.67% (62/120) before intervention to 89.41% (152/170) after intervention, difference was significant (P < 0.001); qualified rate of waste classification increased from 81.34% (763/938) before intervention to 95.94% (1 017/1 060) after intervention (P < 0.05); the weight of medical waste decreased significantly, from 9 540.22 kg before intervention to 6 663.03 kg after intervention (P < 0.001). Conclusion Refined supervision measures improve health care wor- kers' knowledge and classification accuracy of medical waste classification, effectively improve the efficacy of medical waste management, and further standardize medical waste management.