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<strong>Abstract: </strong>The process of siting municipal solid waste landfills in Greece faces significant challenges due to land resource limitations, the country’s mountainous and water-permeable terrain, and strong public opposition. This study introduces a novel methodology for optimizing landfill sites on Lemnos Island in the North Aegean Sea using a Fuzzy Spatial Multiple Criteria Analysis (FSMCA) approach. By combining Fuzzy Sets Theory, Geographic Information Systems (GIS), the Analytic Hierarchy Process (AHP), G-Statistics for Spatial Autocorrelation, and Fuzzy C-Mean for Spatial Clustering, this methodology addresses the uncertainties and complexities inherent in landfill siting. The decision problem is structured hierarchically into five levels to manage multiple criteria effectively. Criteria weights are determined using AHP, with discrete criteria graded according to Greek and EU guidelines, and continuous criteria evaluated through Fuzzy Sets Theory. The region's suitability is assessed using Multiple Criteria Analysis, revealing that 10.2% of Lemnos Island is appropriate for landfill placement. Sensitivity analysis confirms the robustness of the methodology to changes in criteria weights. Case study demonstrate the practical application and benefits of FSMCA in real-world scenario, underscoring its potential to improve sustainable waste management practices and inform policy-making.