Preventing healthcare-associated infections requires a number of actions, including adequate disinfection and sterilization of medical devices. A cost analysis of hospital sterilization processes is fundamental to increase quality and safety, reduce costs and to make a decision about outsourcing. The aim of this analysis was to determine the cost of sterilization and the average cost of surgical procedures at the Rizzoli hospital in Bologna (Italy), a largesurgical hospital that performs more than 11,000 surgical procedures per year.