Purpose <p>Inguinal Hernia Repair (IHR) is a common pediatric procedure with different surgical and anesthetic options. This project quantified and compared differences in environmental impact by analyzing waste generation and carbon emissions arising from anesthesia and surgical processes for infant IHR.</p> Methods <p>A prospective, observational study of pediatric IHR cases in elective patients aged &lt; 1 year was conducted over 1 year. Data collection included operative and anesthetic processes, as well as waste generated/case. Total CO₂ equivalent from inhaled anesthesia was measured, along with the volume of CO₂ used for insufflation. Welch’s t-test was used for analysis, with <i>p</i> &lt; 0.05 considered significant.</p> Results <p>Twenty-two patients were enrolled, 13 underwent open IHR and 9 underwent laparoscopic IHR, using a combination of anesthetic techniques. Laparoscopy produced 22.3% more non-recyclable waste than open procedures (<i>p</i> = 0.0081); no difference in recyclable waste (<i>p</i> = 0.291) or total CO₂ emissions (<i>p</i> = 0.6936). On average, only 7% of CO₂ emissions arose from direct insufflation during laparoscopy.</p> Conclusion <p>Laparoscopy for infant IHR generates more physical waste but produces comparable total CO₂ emissions when compared to the open procedure. The overall carbon footprint of either procedure appears similar, suggesting the planetary impact of these procedures shouldn’t influence choice of technique. More research into environmental stewardship is warranted.</p>