Background <p>Single-use endoscopes have become widely established in urology. They are advocated due to the rapid integration of technological advances, the possibility of bypassing reprocessing requirements, and their potential to address gaps in availability. At the same time, their ecological impact in the context of sustainability is receiving increasing attention.</p> Objective <p>This article critically compares the advantages and disadvantages of single-use endoscopes versus reusable systems, with a&#xa0;particular focus on sustainability and resource consumption.</p> Materials and methods <p>Discussion of fundamental studies and expert recommendations, supplemented by comparisons with data from nonmedical sources on energy and material use as well as waste management.</p> Results <p>Production, packaging, and distribution of single-use endoscopes require considerable resources, since not only plastic elements but also electronic components, image sensors, and sterilization processes are involved. In contrast, reusable systems entail significantly higher consumption of water and chemicals during reprocessing. Evidence from other industries highlights the importance of closed-loop systems and recycling strategies, which are still scarcely implemented for single-use endoscopes.</p> Conclusion <p>Current data suggest that single-use endoscopes may have a&#xa0;worse impact on the environment compared to reusable endoscopes. However, current data do not yet allow for definitive conclusions. Further analyses are required to comprehensively assess resource and energy demands. Introduction of recycling strategies and reuse of particularly resource-intensive components represent promising approaches towards a&#xa0;more sustainable application of single-use endoscopes.</p>