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Background and Importance Short peripheral intravenous catheters (PIVCs) and midlines (MIDs) are medical devices (MDs) used for peripheral intravenous drug administration. Their role in patient management is now well established, but little is known about their environmental impact.Aim and Objectives To calculate the carbon footprint (CF) of PIVC and MID insertion and use in our hospital, based on a patient cohort.Material and Methods The list of MDs required for PIVC and MID insertion was established. Data required for a simplified life cycle assessment were collected from suppliers, including materials, mode of transport, and manufacturing, assembly, and sterilisation sites. Each MD component was weighed by material type, and the CF was determined using the Carebone tool, a life cycle assessment instrument developed by the Assistance Publique–Hôpitaux de Paris (AP-HP). A model was developed to estimate CF according to catheter dwell time and treatment duration, and to identify the treatment length beyond which MID use becomes more sustainable than PIVC. The calculation was then applied to a cohort of 315 patients who received a MID in 2024, allowing estimation of the overall CF.Results Seventeen MDs were required for MID insertion versus eight for PIVC insertion. The CF of a single PIVC insertion was 2.1 kgCO2e, while that of a MID was 7.3 kgCO 2e. The CF of the cohort was 4619 kgCO2e. The mean dwell time was 2 days for PIVCs and 10 days for MIDs. The model showed that for 9 days of treatment, MID use is more sustainable than repeated PIVC insertions. In this cohort, MID use reduced the overall CF by 2355 kgCO2e by avoiding repeated PIVC insertions. From an environmental perspective, MIDs are therefore advantageous for long-term treatments, or when PIVC dwell time is short, particularly in patients with poor venous access.Conclusion and Relevance The choice between MIDs and PIVCs cannot be based solely on environmental criteria, but sustainability can be added to the existing selection factors. A reasoned and thoughtful approach to the use of catheters–and medical devices in general–is essential to reduce the environmental impact of healthcare and to help preserve the environment.Conflict of Interest No conflict of interest