Abstract The survival and persistence of Clostridium difficile spores in the environment are of concern to health care facilities. The endospore form of this organism is resistant to most traditional hospital disinfectants and alcohol-based hand sanitizers. Current hand hygiene and environmental hygiene recommendations focus on physical removal of spores in addition to sporicidal efficacy. Procedure is as important as product choice in eliminating C. difficile from the patient environment. Monitoring environmental hygiene has been successful in this programmatic approach.