In response to the global climate crisis, the healthcare sector, known for its high carbon footprint, has become a critical target for net-zero transformation. Among the key contributors, energy consumption in operating rooms and anesthetic gas emissions are especially significant. Taipei Medical University Hospital (TMUH) leads the nation in this effort by establishing an independently operated Office of Sustainability and launching the "Green Anesthesia" initiative, led by the Department of Anesthesiology.Applying a systematic planning framework, TMUH has implemented low-flow anesthesia techniques and total intravenous anesthesia (TIVA), ensuring both patient safety and quality of care. In collaboration with public health experts, the hospital conducted energy-saving experiments on the HVAC system in operating rooms, demonstrating that temperature regulation and scheduled air conditioning shutdowns can significantly reduce carbon emissions without compromising infection control standards. The hospital has also advanced medical waste reduction efforts and initiated professional training for sustainability officers, embedding ESG principles into clinical practice and institutional decision-making. With these concrete outcomes, TMUH was recognized with the Taiwan Corporate Sustainability Award in 2023, setting a strong example for the healthcare industry in achieving “precise carbon reduction without compromising quality.