Abstarct: This research was conducted with the aim of investigating the impact of Green Human Resource Management practices on sustainable performance, considering the mediating role of green innovation and the moderating role of risk management among employees of Milad and Khatam al-Anbiya hospitals in Tehran. The statistical population of the study consisted of 870 and 710 employees, totaling 1580 employees from Milad and Khatam al-Anbiya hospitals in Tehran, from which a sample size of 339 individuals was selected using cluster random sampling. Data were collected through standard questionnaires and analyzed using structural equation modeling. The findings from the data analysis indicated that all research hypotheses were confirmed. Specifically, the results revealed that the implementation of Green Human Resource Management practices directly and positively leads to the enhancement of sustainable performance in these hospitals. Furthermore, these management practices provide a foundation for strengthening green innovations in hospital processes and services. On the other hand, green innovation itself has a direct and significant impact on improving sustainable performance. Regarding the mediating role, it was found that green innovation acts as an important mechanism, transmitting part of the effect of Green Human Resource Management on sustainable performance. In addition, the findings confirmed the moderating role of risk management in the relationship between Green Human Resource Management and green innovation, meaning that when risk management is actively implemented in the organization, the impact of green human resource practices on fostering green innovations becomes stronger and more effective. In summary, the results of this research emphasize the importance of an integrated and systematic approach, wherein the combination of Green Human Resource Management, environmental innovations, and risk management can pave the way for achieving sustainable and balanced performance in healthcare organizations.