This study investigated the livelihood challenges faced by informal waste pickers in Mahikeng, South Africa and developed intervention guidelines to enhance their socioeconomic conditions. Despite their significant contribution to environmental sustainability and resource recovery, informal waste pickers operate under precarious conditions characterised by economic vulnerability, health risks, and social marginalisation. Using a qualitative research approach, the study employed in-depth interviews with 15 informal waste pickers and three Buy-Back Centre managers followed by a three-round Delphi consultation with nine experts to develop intervention guidelines. The findings revealed six key thematic areas of challenge: precarious livelihoods and economic vulnerability; health burdens; social stigma and marginalisation; operational hurdles and resource constraints; occupational health and safety challenges; and aspirations for dignity and professional recognition. Based on these findings, comprehensive intervention guidelines were developed, focusing on four core components: economic empowerment, occupational safety, infrastructure development, and skills enhancement. The intervention framework follows a phased 24-month implementation timeline with specific strategies for stakeholder engagement and resource mobilisation. This study contributes to understanding the multidimensional challenges faced by informal waste pickers and provides a structured approach to addressing these challenges through collaborative, evidence-based interventions that recognise informal waste pickers as essential environmental service providers.