The environmental impact of healthcare delivery in general, and respiratory-related healthcare specifically, has gained increasing attention in recent years. Reducing national carbon emissions and improving sustainability has become a high priority both at governmental level and for the NHS across the UK. General practice nurses (GPNs) have a critical role to play in addressing the environmental impact of respiratory healthcare. While the priority must always be to do the right thing clinically for individual patients, there are a range of strategies which can be introduced to day-to-day practice to reduce the carbon footprint of respiratory healthcare. This article reviews a range of strategies from protecting and improving the indoor air quality of healthcare facilities and ensuring patients understand and use their prescribed medications effectively, to undertaking a quality improvement initiative to address environmental issues. Integrating sustainable healthcare principles in every aspect of clinical practice can drive the delivery of greener respiratory healthcare that will benefit us all without detriment to delivering high quality care.