Home care services (HCS) are important to assist patients with difficulties in accessing conventional health services. Nevertheless, in times of COVID-19 pandemic, the traditionally offered service needs to be restructured to protect health professionals, patients and their families. In this context, this article aims to identify the impacts resulting from the COVID-19 pandemic on home medical waste management (MWM), converting threats into opportunities, and weaknesses into management strengths. Three months before the pandemic (from October to December), a comprehensive survey was conducted on the practices of home care services and MWM with health professionals, caregivers and patients in Caruaru (Brazil). Quali-quantitative information was collected by structured and semi-structured interviews. For evaluation, the SWOT-TOWS analysis was applied to identify the threats and weaknesses of the practices of HCS and MWM, and to propose strategies to ensure the protection of public health and the environment. The results showed that the main weaknesses found were the lack of training of health professionals and the lack of guidance given by them to caregivers of patients, both related to MWM. Except for sharp waste, all other MWM practices have proved to be inadequate, posing threats, especially in a pandemic period. Four action strategies to improve HCS and MWM were identified: (i) providing MWM training to HCS personnel based on ISO standards; (ii) providing MWM information to caregivers and patients; (iii) planning actions to optimize the service during the pandemic; and (iv) sharing HCS management with municipal decision makers. Between December 2020 and January 2021, semi-structured interviews were performed only with health professionals, to verify the impacts and changes that have occurred in HCS in the COVID-19 pandemic. Comparing the results of the two surveys, improvements were achieved, including the incorporation during the pandemic of some strategies identified in the first phase of the research.Implications: Home care service plays a fundamental role in the quality of life of patients and in the sustainability of the public health system in Brazil. In the pandemic period, HCS was impacted with routine changes and the adoption of new personal protective equipment. Our results showed the need to promote strategies to improve HCS to preserve the health of professionals and patients attended, in the pandemic and post-pandemic period. The strategies identified in the study contributed to improvements in the provision of the service and in the management of medical waste that is still inadequate. Such issues are of interest to municipal health management, which has adopted some of the suggested strategies. The thousands of HCS distributed in Brazilian municipalities can also adopt the strategic actions resulting from this research.