Spent nuclear fuel and high-level radioactive waste can be disposed in deep horizontal drillholes in sedimentary, metamorphic or igneous rocks. Horizontal drillhole disposal has safety, operational and economic benefits: the repository is deep in the brine-saturated zone far below aquifers in a reducing environment of formations that can be shown to have been isolated from the surface for exceedingly long times; its depth provides safety against inadvertent intrusion, earthquakes and near-surface perturbations; it can be placed close to the reactors and interim storage facilities, minimizing transportation; disposal costs per ton of waste can be kept substantially lower than for mined repositories by its smaller size, reduced infrastructure needs and staged implementation; and, if desired, the waste could be retrieved using “fishing” technology. In the proposed disposal concept, corrosion-resistant canisters containing unmodified fuel assemblies from commercial reactors would be placed end-to-end in up to 50 cm diameter horizontal drillholes, a configuration that reduces mechanical stresses and keeps the temperatures below the boiling point of the brine. Other high-level wastes, such as capsules containing 137Cs and 90Sr, can be disposed in small-diameter horizontal drillholes. We provide an overview of this novel disposal concept and its technology, discuss some of its safety aspects and compare it to mined repositories and the deep vertical borehole disposal concept.