Climate change is caused by the accumulation of greenhouse gases (GHG) that trap heat in the atmosphere, resulting in rising temperatures. The healthcare sector is a significant contributor to GHG emissions, accounting for a global average of 4.4% of total emissions, rising to 5.5% in Belgium. The operating room (OR) is disproportionately responsible for 40% of these emissions. The carbon footprint of the OR is mainly composed of waste production, energy consumption, and the emission of anesthetic gases. It is estimated that the OR generates 20 to 30% of hospital waste. Therefore, anesthesiologists have shown an increased interest in sustainable healthcare, particularly in waste management. This narrative review aims to explain healthcare waste management in the Belgian operating theatre and to explore evidence-based approaches to a more sustainable practice based on the waste hierarchy “reduce, reuse, recycleâ€.