The study aimed to measure the study of the accounting and environmental dimension to improve the quality of service performance in university hospitals to achieve the Sustainable Development Goals. The research sample consisted of a number of (80) individuals, 50 individual patients, and a total inventory of 30 individuals, including: (department managers, bosses, employees) of the departments: (accounts, purchases, financial management) .The study belongs to analytical descriptive research, where the questionnaire was used as an essential tool for data collection after preparing a survey list consisting of a set of questions addressed to the research sample (department managers, heads, staff) with the aim of identifying their opinions, analysing them to find out the impact of the hospital's environmental accounting system to enhance its environmental responsibility, reduce environmental pollution,its role to improve the quality of service, achieve sustainable development requirements,and sample (patient) research for knowledge,and take advantage of their opinions to measure the performance of the service provided to them within the requirements of achieving the requirements of achieving the service provided to them. Sustainable development, by 80 forms,50 forms of patients, and 30 comprehensive inventory forms including: (department managers, heads,employees) of departments: (accounts, purchases, financial management). The study has reached many conclusions; the most important of which is:there is a strong statistically significant correlation at a moral level(0.01)between the environmental accounting system, both the environmental dimension and the quality of performance service;and the realization of sustainable development requirements. The study recommended the application of the environmental accounting system in university hospitals to enhance their environmental responsibility,reduce environmental pollution, improve the quality of service,and meet the requirements of sustainable development. Keywords:Accounting dimension-The environmental dimension-Quality of service in hospitals-Hospitals-Sustainable development.