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Improper sanitation and waste management is the number one cause for ill health, disease and death throughout the world, particularly under extremely dense living conditions in refugee camps in the global South. This paper discusses the results of a mixed-method study conducted in Rohingya refugee camps, located in Chittagong, Bangladesh, currently hosting the world's largest concentration of refugees. Our structured questionnaire, group discussion and interviews were centered on waste-borne hazards. The research has evidenced severe challenges associated with overall precarious sanitation and waste situations in the camps. Garbage littering and open defecation are widely practiced. Congested drainage systems contribute to flooding, bringing waste and contaminants into people's homes. Improvements can be made by involving camp inhabitants in decision-making processes and giving them greater ownership in everyday infrastructure maintenance. Our research suggests that community participation is the key tool to maintain proper cleanliness of drains and toilets. Creating a stronger sense of community in the camps and practicing transparency and inclusion in planning and decision-making can contribute to addressing the key threats identified in this research and also apply to other refugee camps worldwide, with similar hazardous living conditions. HIGHLIGHTS Precarious sanitation infrastructure, dense living and improper waste management pose serious challenges in refugee camps.; Lack of planning, inappropriate design and the absence of participation in camp decisions are root causes for environmental contamination in refugee camps.; Community engagement and grassroots participation of refugees are vital to finding appropriate solutions to WASH issues and environmental health.;