Human health depends on a stable climate and anthropogenic climate change is one of the greatest global health threats facing the 21st century [1]. The health sector, committed to preserving human health, paradoxically contributes 4.4% to global greenhouse gas (GHG) emissions [2]. Inpatient hospital settings and operating rooms, in particular, are dramatically high consumers of energy in comparison to other commercial buildings and other units in hospitals. Moreover, the extensive use of hazardous materials and nonbiodegradable single-use devices, as increasingly supported by clinical guidelines, exacerbates environmental challenges [3]. Integration of environmental sustainability in clinical guidelines is essential for safeguarding human health [4]. The European Association of Urology (EAU) acknowledges this need in their Guideline Office strategy, which states that “the environmental effects of specific treatments should be taken into account” and a “healthy environment that limits peoples exposure to damaging toxins and chemicals” should be developed [5]. However, it remains unclear how to pursue these goals. Here we discuss five proposed dimensions for implementation of planetary health in clinical guidelines [4] with a focus on the environmental sustainability of urological care.