Aim: This scoping review aims to identify, categorise, and evaluate current strategies for increasing environmental sustainability in endovascular theatres, assessing their effectiveness for sites seeking to implement them. Background: Combining the output of healthcare worldwide would rank as the 5th-largest greenhouse gas-producing nation, with a significant contribution from operating theatres. Endovascular and hybrid procedures are resource-intensive environments that generate substantial medical waste, with waste disposal contributing significantly to healthcare’s carbon footprint. Multiple strategies have been described as relevant to endovascular theatres, spanning vascular surgery, interventional radiology, cardiology, and neurology. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) framework, a comprehensive search of Medline, Embase and Cochrane Library was carried out. Studies included in the review were selected by two authors (AH and SL) after a blinded review based on their relevance to waste reduction and environmental sustainability in endovascular surgery. Results: Current findings highlight differing themes for interventions to reduce environmental impact, including optimising waste segregation to increase the recycling of uncontaminated medical waste, educating staff to improve decision-making regarding resource utilisation and waste disposal, and enacting hospital-level policies that promote sustainability. Conclusion: Sustainability initiatives in endovascular surgery require a multifaceted approach. This review will explore themes in the literature relevant to endovascular surgery, including current interventions to increase sustainability and reduce waste, and assess their environmental and clinical impact.