Yes, American Airlines—like almost all major carriers in 2026—reuses its pillows, duvets, and blankets in premium cabins (Flagship First, Business, and Premium Economy), but they undergo a rigorous professional laundering and sanitization process between every flight. To align with their 2026 sustainability goals, American has transitioned to pillows made from recycled fibers and distributes them in reusable fabric zipper bags rather than single-use plastic, which has eliminated tons of plastic waste annually. In the Main Cabin (Economy), pillows are often only provided on long-haul international flights and are also laundered for reuse. While the fabric is recycled and reused, you can be assured that every item placed on your seat has been "industrial-strength" cleaned and sealed for your hygiene. If you are concerned about sensitive skin or "used" items, many 2026 travelers choose to bring their own inflatable travel pillow for a guaranteed personal touch.