Introduction: Climate change is a health problem and, at the same time, health systems are important contributors. Hospitals stand out due to their high rates of energy consumption, resources and waste generation. The purpose of the study is to know and identify the determinants of sanitary waste and the measures that can be implemented that allow reducing the production of hospital waste, seeking to achieve a general and updated appreciation of this phenomenon and taking into account hospital sustainability. Method: A bibliographic search was carried out in pubmed that included keywords related to the concepts of carbon footprint, recycling and hospital waste. The screening yielded a total of 37 articles and later 12 publications founded from references (or that were previously known by the authors) were added. Results: The results are presented into 5 points known as the “5 Rs”, named below. “Reduce” (through adequate segregation of waste, correct management of effluents and energy, significant reduction of excesses and automatic administration of anesthetic gases), “Reuse” (through device reprocessing, reusable material and donation), “Recycle”, “Rethink” (with examples such as selection of less polluting gases, selective use of containers, staff education) and “Investigate” through different models. Discussion: Several of the recognized measures could have an application in many hospital areas despite the fact that most of the available evidence refers to the operating room. The organization and education of the personnel is important in order to implement the measures found.