Over the past few years, organisations have faced pressure from stakeholders to adopt environmentally friendly business practices, where it is becoming critical to identify green practices that boost sustainability. Despite green human resource management receiving significant interest from scholars, studies related to green practices remain limited, and are still emerging in a developing countries context. This paper aims to assess the level of implementation of green human resource management practices in Palestinian healthcare organisations, and their impact on sustainable performance in this important service sector. A mixed research approach was adopted by conducting 14 semi-structured interviews with human resource managers, operational managers, and chief executive officers within a range of areas in the healthcare sector in the West Bank. A survey was used as a quantitative tool for data collection from 69 respondents who have been using green human resource management practices at different managerial levels. Partial least squares structural equation modelling was used for data analyses. The findings revealed that green human resource management practices were implemented at a moderate level, where the overall mean of implementation was 2.42 on a scale of 5. Moreover, sustainable performance was achieved at a high level, 3.42 on a scale of 5. Identification and prioritisation of green practices were applied, where the most influential practices were ‘green hiring’, and ‘green training and involvement’; the least influential green practice was ‘green performance management and compensation’. In addition, the path coefficients test revealed that green human resource management practices had a positive influence on sustainable performance, where environmental sustainability had the highest path coefficient of β = 0.478; the lowest impact from social performance measured β = 0.372. This study provides scholars with a better understanding of green human resource management practices in a developing countries context, with empirical evidence of the role of green human resource management practices, in a bid to enhance employee behaviour towards sustainable performance. A framework was developed to provide policy makers with set guidelines on how to influence and implement green human resource management practices for maximised sustainable performance.