PurposeThis paper deals with the combined management and design of a sustainable pharmaceutical supply chain network with considering recycling.Design/methodology/approachThis paper first utilizes the analytical hierarchy process to select and rank green manufacturers. Second, the authors proposed a multi-objective nonlinear mathematical model to design a sustainable pharmaceutical supply chain network. The proposed model has been linearized and solved using the LP-metric method using GAMS software.FindingsA real case study has been conducted in Iran. The results show that environmental and social issues can be improved while minimizing total costs.Originality/valueGiven the criticality and importance of drugs in human health and the importance of recycling in today's world, proper management and design of a sustainable drug supply chain are necessary. This study pays special attention to environmental issues by utilizing multi-criteria decision approaches and customer satisfaction.