Sustainability and the environment are issues influencing individual and organizational choices on purchasing, waste management, and energy-saving practices. The food service industry and related stakeholders have reported active pursuit of initiatives to reduce environmental impacts. We examine reported environmentally friendly practices being implemented in the food service industry and consider ways in which health care or hospital food services can adopt some of these programs. Building and equipment, waste management, food, and non-food supplies and procurement are considered. Suggestions are made for small changes to start the green initiative in each of these areas. A health care food service department is a large consumer of resources, and therefore food service workers, managers, dietitians, and administrators can make a significant difference by supporting and adopting environmentally friendly practices. Further studies are needed to determine which practices are currently being implemented in health care facilities in Canada, as well as perceived facilitators and barriers to these practices in the food service area.