Large-scale incinerators are applied widely as a result of the heavy burden of municipal solid waste (MSW) generated, while strong opposition is arising from the public living nearby. A large-scale working incineration plant of 1500 ton/day was chosen for evaluation using life cycle assessment. It was found that the corresponding human toxicity impacts via soil (HTs), human toxicity impacts via water (HTw) and human toxicity impacts via air (HTa) categories are 0.213, 2.171, and 0.012 personal equivalents (PE), and global warming (GW100) and nutrient enrichment (NE) impacts are 0.002 and 0.001 PE per ton of waste burned for this plant. Heavy metals in flue gas, such as Hg and Pb, are the two dominant contributors to the toxicity impact categories, and energy recovery could reduce the GW100 and NE greatly. The corresponding HTs, HTw and HTa decrease to 0.087, 0.911 and 0.008 PE, and GW100 turns into savings of -0.007 PE due to the increase of the heating value from 3935 to 5811 kJ/kg, if a trommel screener of 40 mm mesh size is used to pre-separate MSW. MSW sorting and the reduction of water content by physical pressure might be two promising pre-treatment methods to improve the combustion performance, and the application of stricter standards for leachate discharge and the flue gas purification process are two critical factors for improvement of the environmental profile identified in this work.