Bulk mineral waste materials are one of the largest waste streams worldwide and their management systems can differ greatly depending on regional conditions. Due to this variation, the decision-making context is of particular importance when studying environmental impacts of mineral waste management systems with life cycle assessment (LCA). We follow the premise that LCA results—if applied in practice—are always used in an improvement (i.e., decision-making) context. But how suitable are existing LCA studies on bulk mineral waste management for decision support? To answer this question, we quantitatively and qualitatively assess 57 peer-reviewed bulk mineral waste management LCA studies against 47 criteria. The results show inadequacies regarding decision support along all LCA phases. Common shortcomings are insufficient attention to the specific decision-making context, lack of a consequential perspective, liberal use of allocation and limited justification thereof, missing justifications for excluded impact categories, inadequately discussed limitations, and incomplete documentation. We identified the following significant issues for bulk mineral waste management systems: transportation, the potential leaching of heavy metals, second-order substitution effects, and the choice to include or exclude avoided landfilling and embodied impacts. When applicable, we provide recommendations for improvement and point to best practice examples.