This study investigates the impact of sustainable supply chain management on procurement environmental performance, focusing on the relationship between hospital procurement personnel and suppliers. The research combines resource dependence theory (RDT) and environmental relationship quality theory, incorporating environmental factors, subjective environmental norms, and perceived environmental values. A questionnaire survey was conducted with 443 hospital procurement personnel, and structural equation modeling was used to validate the hypotheses. The results show that environmental trust and commitment positively affect environmental performance, while supplier importance and substitutability positively impact environmental commitment. Supplier uncertainty also positively influences environmental trust and commitment. Perceived environmental value positively affects environmental commitment but not environmental trust. Environmental subjective norms positively influence both environmental trust and commitment. These findings provide insights for hospitals to improve their procurement environmental performance and promote green procurement policies.This study investigates the impact of sustainable supply chain management on procurement environmental performance, focusing on the relationship between hospital procurement personnel and suppliers. The research combines resource dependence theory (RDT) and environmental relationship quality theory, incorporating environmental factors, subjective environmental norms, and perceived environmental values. A questionnaire survey was conducted with 443 hospital procurement personnel, and structural equation modeling was used to validate the hypotheses. The results show that environmental trust and commitment positively affect environmental performance, while supplier importance and substitutability positively impact environmental commitment. Supplier uncertainty also positively influences environmental trust and commitment. Perceived environmental value positively affects environmental commitment but not environmental trust. Environmental subjective norms positively influence both environmental trust and commitment. These findings provide insights for hospitals to improve their procurement environmental performance and promote green procurement policies.