This study examines the historical relationship between urban development, waste management, sanitation, and public health in Jos Metropolis between 1976 and 2023. This is against the growing concerns of climate change, rapid urban development and population growth and the growing public health, in conjunction with inadequate literature on the environmental history of Jos metropolis. The study adopts a historical approach, where sources are drawn from both primary and secondary sources; this include the city master plan, published books and journals environmental regulations, institutional reports, healthcare and waste in Jos. The analysis is organised into four broad phases: the post-1976 period of planned expansion; the institutional and economic crises of the 1980s and 1990s; the establishment and consolidation of the Plateau Environmental Protection and Sanitation Agency (PEPSA) after 2000; and the fragmented, increasingly participatory but still precarious sanitation regime of 2011–2023. Findings show that the 1976 Greater Jos Master Plan provided an important planning opportunity, but urban growth subsequently outpaced the infrastructure and institutional arrangements designed to manage it. Public drains, culverts, vacant land, streams, and road margins became informal extensions of the municipal waste system. At the same time, households, informal recyclers, private operators, health institutions, markets, religious organisations, and civil-society groups developed practical responses that official policy often overlooked. The study concludes that a robust public-health strategy for Jos requires historical accountability, integrated metropolitan governance, investment in collection and final disposal, recognition of informal environmental labour, and sanitation policies designed with communities rather than imposed upon them.