The paper aims to show peculiar Italian Healthcare Organizations called Scientific Research, Hospitalization and Healthcare Institutes (indicated with the Italian acronym IRCCSs) can exploit their distinctive competencies also in the sustainable environmental management of their businesses. The methodology followed in the paper to reach this aim, starts from the analysis of the sustainable environmental management in the European healthcare sector, and from the identification of the role of IRCCSs in the Italian National Health System (NHS). Successively, it is evaluated how IRCCSs can integrate their strategic objectives with those of environmental nature and then, whether IRCCSs pursue sustainable environmental strategies. Finally, the paper indicates which are the environmental strategies, adopted by the IRCCSs, among those available. The main finding of the paper is the assessment that the distinctive competencies of IRCCSs to manage relationships, exploit strategic interdependencies, and generate innovation allow them both to integrate environmental sustainability into governance systems and to disseminate new knowledge, responding to the challenges of the environmental transition. The study opens for possible future research on the interdependencies that could be observed between sustainable environmental, social, economic and ethical strategies within IRCCSs.