The article discusses the role of the environment in the evolution and transmission of antibiotic resistance. Antibiotic resistance is a global health challenge, driven by the transfer of bacteria and genes between humans, animals, and the environment. While barriers restrict the flow of bacteria and genes, pathogens recurrently acquire new resistance factors from other species, reducing our ability to prevent and treat bacterial infections. The environment, including antibiotic pollution, plays a significant role in resistance evolution and transmission. The authors highlight the importance of understanding the pathways and drivers of environmental evolution and transmission to manage the resistance crisis effectively. They provide insights into the current understanding of the environment's role in resistance, describe risk scenarios, discuss methods for surveillance, and identify actions to mitigate risks, particularly in low- and middle-income countries. The article also emphasizes the need for intensified actions in these regions, overlapping with strategies to improve water quality, sanitation, and hygiene. Additionally, it discusses the role of the environment in reflecting the clinical resistance situation and the potential of sewage surveillance as a complementary tool to traditional clinical surveillance. The authors conclude by outlining the challenges and future directions in studying resistance in the environment and reducing environmental risks.The article discusses the role of the environment in the evolution and transmission of antibiotic resistance. Antibiotic resistance is a global health challenge, driven by the transfer of bacteria and genes between humans, animals, and the environment. While barriers restrict the flow of bacteria and genes, pathogens recurrently acquire new resistance factors from other species, reducing our ability to prevent and treat bacterial infections. The environment, including antibiotic pollution, plays a significant role in resistance evolution and transmission. The authors highlight the importance of understanding the pathways and drivers of environmental evolution and transmission to manage the resistance crisis effectively. They provide insights into the current understanding of the environment's role in resistance, describe risk scenarios, discuss methods for surveillance, and identify actions to mitigate risks, particularly in low- and middle-income countries. The article also emphasizes the need for intensified actions in these regions, overlapping with strategies to improve water quality, sanitation, and hygiene. Additionally, it discusses the role of the environment in reflecting the clinical resistance situation and the potential of sewage surveillance as a complementary tool to traditional clinical surveillance. The authors conclude by outlining the challenges and future directions in studying resistance in the environment and reducing environmental risks.