To reinforce competitiveness, companies must focus on competitive priorities including cost, quality, delivery, and flexibility. The competitiveness also depends on the adherence to environmental requirements and the ability of companies to survive unforeseen disruptions . Lean, agile, resilient, and green (LARG) paradigm is a hybrid supply chain paradigm, which can enhance competitiveness in today's complex markets. In this article, we propose a new conceptual decision-making model to evaluate LARG supply chain performance in medical equipment companies. In this regard, supply chain operations reference model attributes were utilized as performance evaluation criteria. Furthermore, the appropriate practices of LARG supply chain are selected through fuzzy Delphi method. Also, an extension of decision making trial and evaluation laboratory-based analytic network process method is proposed to uncover network relationships and obtain the weights for dimensions and elements. According to the results, the agile paradigm, responsiveness, and quick introduction of new products are determined as the most prioritized elements in their corresponding dimensions, which emphasize the importance of the customer satisfaction. Finally, the extended hesitant fuzzy linguistic VIKOR (Vlsekriterijumska Optimizacija I Kompromisno Resenje) is applied to rank LARG performance of Iranian needles and syringes companies via qualitative group decision-making process. The results of this study are conformed to conventional selection results of needles and syringes suppliers conducted by Iran's Ministry of Health.