Aims: The healthcare sector is a growing contributor to global environmental impact. There is increasing awareness of the need for sustainable practices including the choice between single-use and reusable instruments. Nasal specula are commonly used instruments in otolaryngology outpatient clinics. The purpose of this study is to assess the environmental and economic cost of single-use versus reusable nasal specula in this setting. Methods: An economic evaluation of total cost of ownership was conducted based on institutional use assumptions of 652 nasal examinations over a one-year period and purchase of 10 reusable specula in a tertiary otolaryngology outpatient clinic. The environmental impact of single-use and reusable nasal specula was assessed with a cradle-to-grave life cycle assessment, using the ReCiPe 2016 Midpoint & Endpoint (H) V1.03 methods. The functional unit to compare single-use and reusable specula was the estimated annual use of a single reusable speculum in our institution. Results: Cost analysis estimated a total cost per use of $5.01 for single-use and $1.19 for reusable specula in the first year, with cost effectiveness improving in subsequent years for reusable specula. Reusable specula become more cost-effective after approximately 108 nasal examinations per year. Life cycle analysis reveals that reusable nasal specula significantly outperform single-use instruments across Human Health and Natural Resource, with a small advantage for Ecosystem Quality endpoints. Midpoint outcomes showed reusable nasal specula outperform single-use across the majority of midpoints. Conclusion: Reusable nasal specula demonstrate a clear economic advantage over single-use alternatives in a single tertiary centre experience. Life cycle analysis highlights reusable specula have less environmental impact. This research provides evidence to support the purchase of reusable nasal specula in moderate to large volume otolaryngology centres.