As hospitals face severe financial constraints, the need to review programs to ensure cost-effectiveness is critical. Waste management practices have come under scrutiny because inappropriate waste disposal is very costly. The Wellesley Hospital in Toronto, Ontario conducted a waste audit in July 1993 and found that 18.5% of waste was being disposed of as biomedical waste. Because the hospital pays nine times more to dispose of biomedical waste than it does landfill waste, a goal was set to reduce biomedical waste to 8% of total waste. A program, which included redefining biomedical waste, reviewing waste practices throughout the hospital, educating staff and monitoring outcomes, resulted in biomedical waste levels decreasing to 7.9% of total waste within 18 months. Savings realized were approximately $67,000. This program is easily reproducible.