Waste-to-energy incineration provides an effective solution for efficient and effective municipal solid waste (MSW)disposal, and plays an important role in the regional circular economy and sustainable urban development. However, waste-to-energy incinerations face considerably strong opposition from the local community globally because of the potential hazards to environment and health. This paper conducts a comprehensive case study of the Yuhang Jiufeng waste-to-energy plant in Zhejiang province, which is regarded as first waste-to-energy incineration project to truly overcome such an issue in China. The results reveal that the traditional technical-based, closed Decide-Announce-Defend decision-making approach is the root cause of public opposition, and a more open and democratic publicly involved approach played an important role in the successful re-decision-making of the Jiufeng plant. Meanwhile, a series of response strategies, such as compensation and risk communication, can effectively promote the local residents’ public acceptance through improvements in their benefit/risk perceptions and public trust. The findings of this study will add new knowledge to the current understanding of public opposition, and benefit both governments and waste-to-energy professionals by paving the way to enhancing public acceptance of waste-to-energy incineration facilities.