The lack of agreement on the use of over-shoes tends to perpetuate the ritual of their use in general operating theatres. However, the limited evidence which supports their use in such settings is not applicable in a Day Surgery Unit where their use is not recommended. In order to reduce overt contamination in the unit theatre, a local protocol should be drawn up specifying the use of designated day unit footwear for those that remain within the unit and for all persons entering the operating theatre.