Gastrointestinal (GI) endoscopy services are in third place as major contributors to CO emissions among healthcare facilities, especially due to their massive waste production. One of the measures suggested to reduce this environmental impact is a reduction in histological examinations performed on biopsy specimens taken during endoscopy. A reliable candidate to reduce the rate of biopsies and, consequently, the impact of CO emissions could be EndoFaster, an innovative medical device that allows one to suspect or rule out both infection and precancerous lesions on the gastric mucosa by analyzing a small amount of gastric juice aspirated during endoscopy in real time. In the present study, we investigated the ability of EndoFaster to reduce the environmental impact of upper endoscopy, comparing the CO production of standard biopsy sampling as suggested in guidelines and biopsies guided by real-time EndoFaster results during endoscopy. By estimating an overall 90% rate of biopsies according to standard guidelines and a reduction of 50% of gastric biopsies based on EndoFaster results, we calculated a 44% overall reduction in CO emissions, demonstrating that by using this tool, it is possible to distinctly reduce the contribution of upper endoscopy to global warming.