Purpose <p>Waste management in hospitals is important for environmental sustainability, as disposal of operations waste causes substantial greenhouse gas emissions. This study aimed to identify factors influencing waste generation in orthopaedics and traumatology.</p> Methods <p>In this prospective study, the weight of waste and drapes from 272 orthopaedic and trauma operations was measured. Waste production was analyzed regarding to anatomical region, operation type, and duration.</p> Results <p>Analysing all operations, the amount of waste differed significantly between anatomical regions (<i>p</i> &lt; 0.001). When separating drapes, no significant differences between anatomical regions were found in waste, but in drapes (<i>p</i> &lt; 0.001). The amount of waste differed significantly between operation types and correlated significantly with the operation duration (<i>p</i> &lt; 0.001).</p> Conclusion <p>Operating room waste is influenced by anatomical regions and the drapes required for it. Operation duration significantly increases the amount of waste. These findings can support the development of targeted strategies to reduce waste in operating rooms.</p>