Preventing disease transmission in patients and healthcare workers has taken on greater significance in today’s healthcare environment with the emergence of new pathogens, multi-drug resistant organisms, and increased economic pressures to reduce healthcare associated infections (HAIs). Recent evidence suggests that environmental contamination plays a role in transmission of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), norovirus, Acinetobacter baumannii, and Clostridioides difficile (formerly Clostridium difficile) and other emerging pathogens such as Candida auris in healthcare settings. All of these pathogens survive on healthcare surfaces for a prolonged period of time and previously contaminated rooms increase the risk of transmission to a new patient. While it has become clear that disinfection of the environment can reduce the transmission of healthcare-associated pathogens, many patient areas are not well-cleaned. This continuing education activity will address the role of environmental contamination in the transmission of HAIs, describe the latest research on environmental hygiene in the operating room (OR), and list the monitoring methods available to objectively evaluate environmental hygiene. Process improvement methods and new technologies such as self-disinfecting surfaces and “no touch” area cleaners utilizing ultraviolet (UV) irradiation and hydrogen peroxide vapor will be described. Also discussed are best practices for developing a programmatic approach to improve environmental hygiene in order to make the OR a safer environment for patients and staff.