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Purpose With the low contribution of the manufacturing sector to the gross domestic product, increasing competition among manufacturing industries in Tanzania, and the need to comply with international standards and regulations. Industries are now adopting Lean Six Sigma (LSS), although the benefits and advantages of the LSS are still unknown for developing countries such as Tanzania. Therefore, the purpose of this study is to determine the relationship between LSS and sustainable performance in the aspects of economic, social and environmental performance. Design/methodology/approach A survey research design was employed, using purposive sampling to collect data from 258 manufacturing industries via structured questionnaires. SPSS was used for analysing demographic data, while SmartPLS was applied for partial least squares structural equation modelling. Measurement model validity was assessed using Cronbach’s alpha (≥0.6), composite reliability (≥0.7), average variance extracted (≥0.5) and discriminant validity (≤0.9). Structural model significance was evaluated through t-values (≥1.96), p-values (≤0.05) and model fit indices such as standardised root mean square residual and normed fit index. Findings The adoption of LSS affects organisations’ economic, social and environmental performance. Economically, includes an increase in the profit and sales of the organisation while decreasing the cost of the material purchased, the cost of the energy consumed, and the production cost per unit. Socially, includes an increase in the education and training programmes for employees, a decrease in the turnover ratio of the employees and the number of occupational-related accidents in the organisation. Environmentally, includes the reduction of air emissions, consumption of hazardous materials, energy consumption and waste resulting from the operations of the organisation, and an increase in recycled materials. Research limitations/implications The study’s generalisability is limited due to its focus on a small geographic area. Nevertheless, the findings offer valuable insights for Tanzanian industries, encouraging broader LSS adoption. Practical implications The results can support policymakers in crafting strategies to enhance sustainability in manufacturing, aligning with national and international development goals. Originality/value To the best of the authors’ knowledge, this is the first study to be conducted in Tanzania. It provides a foundational reference for promoting LSS adoption in Tanzania and other developing nations with similar industrial contexts.