What if the equipment decisions made at the end of a project should have guided the design from the beginning? Sterilizers are routinely treated as late-stage equipment selections, finalized after floor plans are locked and systems are already coordinated. But sterilizers don't behave like typical equipment. They behave like infrastructure. When they're treated as an afterthought, the consequences cascade through mechanical systems, structural layouts, space planning, and long-term building performance. This session reframes how design professionals think about sterilization systems using real project examples and current sustainability trends. Participants will leave with a practical framework for identifying sterilization-driven design risks earlier, understanding centralized versus point-of-use support strategies, and making informed decisions that protect project delivery and the long-term health, safety, and welfare of building occupants.