Objective This research examines current waste management within an operating room at a large United Kingdom National Health Service (NHS) hospital. The study measured the volume and type of waste produced for primary hip operations (PHOs) and estimated the total waste produced across the United Kingdom by the procedure. Methods Three PHOs were audited to measure and compare the waste volumes generated. Results The average volume of waste per surgical procedure was 10.9 kg, consisting of clinical (84.4%), recyclable (12.8%) and bio-bin (2.8%) waste. This research also found that single-use devices contribute significantly to operating room waste. In addition, it was estimated that there is a missed opportunity to reduce clinical waste volume in each procedure, where approximately 15% of clinical waste disposal consisted of visibly clean recyclable waste material, including cardboard and plastics. Conclusions It was estimated that in the NHS approximately 1043 tonnes of waste is produced annually by PHOs alone. A significant volume of this waste could be prevented through improved recycling and reduced use of single-use devices.