This paper focuses on the conceptual design optimization of liquid hydrogen aircraft and their performance in terms of climate impact, cash operating cost, and energy consumption. An automated, multidisciplinary design framework for kerosene-powered aircraft is extended to design liquid hydrogen-powered aircraft at a conceptual level. A hydrogen tank is integrated into the aft section of the fuselage, increasing the operating empty mass and wetted area. Furthermore, the gas model of the engine is adapted to account for the hydrogen combustion products. It is concluded that for medium-range, narrow-body aircraft using hydrogen technology, the climate impact can be minimized by flying at an altitude of 6.0 km at which contrails are eliminated and the impact due to NOx\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\hbox {NO}_{\ extrm{x}}$$\\end{document} emissions is expected to be small. However, this leads to a deteriorated cruise performance in terms of energy and operating cost due to the lower lift-to-drag ratio (– 11%) and lower engine overall efficiency (– 10%) compared to the energy-optimal solutions. Compared to cost-optimal kerosene aircraft, the average temperature response can be reduced by 73–99% by employing liquid hydrogen, depending on the design objective. However, this reduction in climate impact leads to an increase in cash operating cost of 28–39% when considering 2030 hydrogen price estimates. Nevertheless, an analysis of future kerosene and hydrogen prices shows that this cost difference can be significantly decreased beyond 2030.