ABSTRACT Background: Debate about sustainable development has reached a peak, as it is now recognized worldwide by public opinion and, in general, by governments’ political agendas. New hospitals need to be made more sustainable and existing ones must improve their standards: e.g. in Italy, more than 50% of all healthcare facilities were built before the Nineties, without any attention to environmental, so-cial or economic sustainability. Methods: Thanks to a sustainability evaluating system (environmental, social and economic) designed by the Milanese University ‘Politecnico di Milano’, two healthcare facilities were analyzed and compared. Both structures have approximately 600 beds and are located in the Lombardy region but they were ...