Environmental degradation, the number one threat to humanity, is increasingly impacting health. Healthcare systems contribute significantly to this pollution, particularly through greenhouse gas emissions from pharmaceuticals. Healthcare professionals can take action by reducing the use of low-value medicines, as recommended by "smarter medicine - Choosing Wisely Switzerland." This convergence between eco-friendly medicine and Choosing Wisely initiatives is illustrated in this article by an "eco-top 5 list" of drugs whose reduced use would benefit both patients and the environment.