Background Environmental problems associated with hospitals mainly relate to waste generated as a result of hospital activities, for example infectious waste and chemicals from laboratories, chemicals from X-ray machines and others, but also to energy usage and purchasing practices. Particularly due to the complicated nature of waste management processes in hospitals, the application of integrated environmental management is difficult. Staff members are often inadequately equipped to deal with and promote safe environmental practices. Objectives The “e-hospital EMAS” project aimed to demonstrate the use the EMAS (Eco-Management and Audit Scheme) regulation (No 761/2001) as a tool for developing environmental policies and action programmes in two hospitals in Athens, and for establishing appropriate administrative structures. Other objectives included: To introduce best practices in the health sector To promote energy efficiency, sustainable waste management and green purchasing in Mediterranean hospitals To promote integrated environmental management through the use of information technology To develop an up-to-date software tool for EMAS in large organisations To raise environmental awareness through EMAS implementation and use of information technology in hospitals and other organisations in Mediterranean countries.Results The environmental benefits of the project derive from the implementation of the EMAS Regulation in a new sector (hospitals) in Greece. New practices in the areas of hospital waste management, energy efficiency and green purchasing are already being implemented in the two participating hospitals. These are expected to increase in the long term through the ongoing implementation of EMAS and the continual setting of higher environmental targets. More importantly, it is hoped they will provide an example to other hospitals in Greece. Of the two participating hospitals, Asklepieio and Metropolitan, only Asklepieio achieved EMAS verification, becoming the first hospital in Greece to achieve this benchmark. As a new hospital, Metropolitan has sound environmental performance in many respects, however EMAS verification is still pending, owing to the expansion of the hospital's premises and the need for an environmental permit. The procedure for getting this permit was still ongoing at the time of the project's completion. Through this LIFE project, the opportunity to apply the EMAS Regulation in hospitals generated valuable outcomes for its applicability and effectiveness in different institutional and administrative environments. Moreover, it created good practice examples not only for other hospitals, but also for other health sector enterprises, which the dissemination activities targeted. The project developed EMAS software that was able to diminish bureaucratic procedures and enhance monitoring and evaluation in a large organisation. The software developed by the project may assist health- and service sector organisations handling environmental problems to carry out their work an organised and up-to-date way. The e-Hospital EMAS Guide (with the EMAS software tool) generated significant interest among hospitals, national and regional health authorities and the Society of Health Inspectors after the project’s final conference. The Guide (in Greek and English) is available both on the project website and on CD-ROM (Annex III of the FR). It has also been promoted in Italy through a visit to hospitals in Siena by the project team. Further information on the project can be found in the project's layman report (see "Read more" section).