Cigarette butts (CBs) are the most diffuse waste in the world, often abandoned into the environment without proper disposal. They are dangerous because of the numerous harmful chemicals potentially released by them into the environment. In the literature, there are several technological options for CB recycling, but some critical concerns could affect their effectiveness due to the quality and quantity of CB litter that is collected in the proper way. The extended producer responsibility scheme for CBs is proposed at the Europe level as an action to tackle CB litter and encourage sustainable product development. The present paper focuses on analyzing the existing literature to identify critical issues within the policy framework, social behavior, waste collection and transport, and technological processes. The collection and transport of CB waste is a major issue, being a key step for bringing CB to the recycling process. The main concern is the small quantity of CBs collected: 0.06% of the municipal waste and 0.18% of the unsorted waste in the case study’s administrative area of Perugia. Another crucial issue is the need for behavioral interventions to increase education and awareness of citizens that are smokers, addressing the discrepancy between smokers’ behaviors and beliefs. The main results, along with the critical issues related to the topics, are highlighted.