OBJECTIVES: The increasing penetration of endoscopic techniques in surgical procedures has resulted in a more frequent use of rigid endoscopes (RE). Several studies have reported significant reductions in the number of damaged RE and repairs when reprocessed with SterradTM instead of Steam. The aim of this study was to analyze the economic consequences of RE sterilization with SterradTM versus Steam from a hospital perspective. METHODS: A dynamic excel-based decision-analytic model was developed. Published literature was used to estimate the two key variables (% of RE damage with Steam as well as with SterradTM). A two-way sensitivity analysis was conducted (varying the two key variables up to ±25%, thus generating 121 different scenarios). Input data for the model collected as an average from four Spanish hospitals were: 1000 RE sterilization units (StU) annually, 2000€ cost for every RE repair and 0,56€ in consumables/StU with Steam. 11,99€ in consumables/StU with SterradTM was calculated based on list prices and an average of 2.5 RE per sterilization cycle. The analysis covered a one year time horizon and assumed 100% utilization for each sterilization technology. RESULTS: A 21% budget impact decrease was achieved with SterradTM versus Steam, leading to 11,870€ in annual savings. The more costly sterilization process (11,986€ versus 560€ per year) was clearly more than compensated by the reduction of 23,296€ in RE repair costs. The sensitivity analysis showed in 100% of the scenarios that SterradTM was cost-saving compared to Steam. CONCLUSIONS: This analysis adds a new component of support for the sterilization of rigid endoscopes with SterradTM by demonstrating that it is cost-saving compared to reprocessing with Steam. Despite the conservative approach of the model which may be in favour of Steam, use of SterradTM led to savings of 21% in the hospital budget.