Today the operating suite is considered, together with the diagnostic unit, the functional area that is more subject to profound changes, resulting in an increased technological complexity. The road paved by the new approaches to care and illness imply that the coming years will be characterized by a profound and radical change of the medical-scientific knowledge and even more so of the diagnostic and therapeutic methodologies. This paper analyses the characteristics of existing healthcare facilities, with respect to the needs created by the new role of the hospital, as well as the impacts on the more complex and rapidly changing sectors. The identification of the problems and the definition of the number of needs will allow to outline the strategies to adopt for the design of a modern operating suite, defining the basic requirements for an optimum supply of the service. The objective will be to define useful design criteria and methods to favour the inclusion process of innovative factors, so that the building unit can promptly respond to any evolution of needs, overcoming the now consolidated spatial and functional obsolescence that has characterized it lately.