Sustainability in radiology requires awareness and active participation from all stakeholders. Radiologists and radiographers can make a significant contribution by using contrast agents appropriately and avoiding waste. Patients can actively participate by collecting their urine containing contrast agents, enabling the possibility of recycling. Manufacturers of contrast media play an important role by improving packaging sustainability and offering recycling programmes. In addition, an optimized workflow is essential for the efficient use of energy-intensive equipment such as CT and MRI scanners. Awareness and policy development regarding sustainability must take place at all levels—from a green team within the department to radiological societies at national and international levels.