An environmentally sustainable healthcare system is one that has no cumulative harmful impacts on the natural environment or society, while providing high-quality healthcare and being financially viable. ‘Green’ initiatives such as improving energy efficiency and promoting recycling are important, but healthcare organisations need to act more broadly to reduce carbon and resource use by developing integrated models of care, strengthening primary care, and optimising use of new technologies. In this Position Statement, the Royal Australasian College of Physicians (RACP) reaffirms its commitment to raising awareness about and advocating for environmentally sustainable healthcare, and calls upon Australian and New Zealand Governments to implement a comprehensive strategy for measuring the carbon footprint of the Australian and New Zealand health sectors, and to establish Healthcare Sustainability Units to lead this vital work.