The purpose of this study was to assess the current application of Environmental Accounting (EA) in hospitals and networks of health care facilities, and to evaluate the applicability of EA for pursuing waste minimization and environmental supply chain management. In particular, we focused on EA for improving decision-making in hospitals in two applications: Product selection. Hospitals routinely make decisions about which products to procure based upon their cost. Identifying environmental costs associated with the life cycle of a product can assist materials managers in selecting products with the lowest life cycle costs, i.e., the lowest costs accrued throughout the life cycle stages of a product. Waste management. Hospitals generate large quantities of waste whose treatment and disposal options are dictated by the waste stream's composition. Because disposal costs are environmental costs, attempts to minimize these costs can benefit from environmental accounting. Additionally, by allocating, or tracking waste management costs back to the products or activities generating waste, managers can make more informed decisions about the products they procure or the activities they undertake.