This study investigates the role of institutions in environment-health outcomes nexus in sub-Saharan African over the period 1996-2016. The study employs different surrogates for capturing the three key variables of concern. These include institutions consisting of control of corruption, government effectiveness, and regulatory quality; environment comprising of carbon emissions and ecological footprints; and health outcomes involving human longevity, child mortality and health expenditures respectively. The study is based its empirical estimations on system of generalized method of moments, of which the following findings are established: First, environmental degradation captured with carbon emissions and ecological footprint is found to reduce human life expectancy by substantial statistical magnitudes. Second, carbon emissions are found to amplify the infant mortality rates, even when the variable interacts with institutional quality variables like government ineffectiveness and poor regulatory quality. Third, both carbon emissions and ecological footprint are found to escalate the cost of health expenditure, but with the dominating influence of the former over that of the latter. Fourth, the defective nature of the African institutional environment receives further empirical validation. Lastly, some other auxiliary variables specific to each health surrogate are also acknowledged. On the policy ground, reducing carbon emissions and strengthening institutional environment hold the key to improving health and other health-related outcomes.