This article examines the consequences of a significant spent fuel management decision or event in the United States, South Korea and Taiwan. For the United States, it is the financial impact of the Department of Energy’s inability to take possession of spent fuel from commercial nuclear power companies beginning in 1998 as directed by Congress. For South Korea, it is the potential financial and socioeconomic impact of the successful construction, licensing and operation of a low and intermediate level waste disposal facility on the siting of a spent fuel/high level waste repository. For Taiwan, it is the operational impact of the Kuosheng 1 reactor running out of space in its spent fuel pool. From these, it draws six broad lessons other countries new to, or preparing for, nuclear energy production might take from these experiences. These include conservative planning, treating the back-end of the fuel cycle holistically and building trust through a step-by-step approach to waste disposal.