The increasing complexity in hospital waste management requires innovative solutions that integrate sustainability and regulatory compliance. This study proposes an AI-based decision tool to support the circular management of healthcare waste. The approach combines two key elements: (i) the systematic qualitative analysis of international, European, and national regulations, scientific literature, and best practices aimed at identifying strategic actions; (ii) the prioritization of these actions through machine learning, using a Random Forest classifier. We identified 55 actions, grouped into 13 thematic areas, and used them as input variables to assess their impact on regulatory compliance. The variable importance analysis allowed us to classify actions according to their strategic relevance, guiding the structure of the tool and its user interface. Validation, conducted on four simulated case studies, demonstrated the system’s ability to improve compliance monitoring, operational efficiency, and the implementation of circular economy and Zero-Waste strategies. The proposed model represents a scalable and evidence-based solution capable of supporting the ecological transition of healthcare facilities in line with EU directives and the Sustainable Development Goals.