This study examines the impact of US sanctions on environmental quality of target countries during the period 1995-2022. Using DID method and an event study approach, we find a significant detrimental impact of US sanctions on environmental health. Notably, these sanctions lead to deteriorating air quality, compromised drinking water safety, elevated levels of heavy metals, and worsened waste management. In addition, we show that the adverse effect of sanctions on environmental health i) is greater for multilateral sanctions than unilateral sanctions; ii) is more pronounced when targeting a single country compared to multiple targets, iii) is primarily driven by economic sanctions (trade and financial sanctions), iv) increases with the severity of sanctions, and v) decreases over time, but does not fully dissipate until 9.7 years later. We also identify two primary mechanisms: increased natural resources dependency of the economy, and reduced urgency of environmental sector in public policy.