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Medical conferences drive high-quality healthcare, foster collaboration and catalyse collective learning.1 In today’s climate, however, it is important to weigh these benefits against the contribution to climate change-related health consequences1 and the financial costs for attendees during a cost-of-living crisis.2 Many conferences, including the Royal College of Paediatrics and Child Health (RCPCH), have introduced hybrid online and in-person formats, enhancing accessibility and sustainability.1 3 We attempt to approximate the residual climate and financial impacts and add to the ongoing conversation regarding whether they can be justified.