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90, 95% CI, 0.86 to 0.95; P0.001). This resulted in a reduction of 53 g CO e (95% CI, 24 to 83g; P0.001) and $22 (95% CI, $9 to $34; P=0.001) in pathology fees per admission. The intervention was estimated to have saved 132kg CO e (95% CI, 59 to 205kg) and $53,573 (95% CI, 22,076 to 85,096). Reduction in unnecessary hospital pathology collections was associated with both carbon emission and cost savings. Pathology stewardship warrants further study as a potentially scalable, cost-effective, and incentivising pathway to lowering h