Background: The responsibility of a surgeon extends beyond the operating table to encompass the environmental impact of their practices. This study aims to explore the environmental impact and surgical site infection risk of reusable surgical headwear compared to disposable headwear, reflecting the evolving role of surgeons in promoting sustainable healthcare practices. Methods: We conducted a systematic review and meta-analysis according to PRISMA guidelines, screening studies from MEDLINE, Embase, Scopus, Google Scholar, PubMed, and Cochrane Library until December 10, 2023. Studies were assessed for suitability, risk of bias, and heterogeneity using ROBINS-I, with results aggregated using RevMan for odds ratios (OR) and 95% confidence intervals (CI). Results: This systematic review included 9 studies, with a meta-analysis of 6 studies involving 45,708 procedural cases. There is no significant difference in SSI rates between reusable and disposable headwear (OR 0.79; 95% CI 0.59 – 1.07; P=0.13). Policy implementation did not significantly affect SSI rates (OR 1.21; 95% CI 0.85 – 1.73; P=0.30). Reusable options showed lower carbon footprint, ozone depletion, fossil fuel use, and freshwater toxicity. Conclusion: This study stands out as the first to collectively analyze data from 45,708 procedural cases demonstrating that reusable surgical headwear matches disposables in SSI prevention and offers substantial environmental advantages. These findings support a shift towards reusable headwear in healthcare, aligning patient safety with ecological responsibility. Such a change contributes to planetary health and highlights the surgeon's role in sustainable medical practices.