Municipalities in the Kingdom of Saudi Arabia (KSA) are managing their municipal solid waste management (MSWM) systems without a structured performance assessment mechanism. For long-term sustainability, all the key components of a MSWM system need to perform efficiently. Identifying suitable performance indicators (PIs) for the regions without having an established performance benchmarking process is a daunting task. A framework is developed to select the PIs for seven key components of MSWM systems, including public service and participation, personnel, physical assets, operational, environmental, sustainability, and financial. Initially, 87 potential PIs were identified under these components through an exhaustive review of literature and expert knowledge. Interview surveys were conducted with decision-makers from two municipalities and academia in the Qassim Region of KSA to evaluate the PIs against three decision criteria, i.e., “relevance,” “measurability,” and “understandability.” For addressing the uncertainties due to vagueness in group decision-making, criteria weights were established through fuzzy analytic hierarchy process (FAHP) while the linguistic scores (defined as fuzzy numbers) were aggregated using the Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE II). Finally, 61 PIs were selected and ranked, for the seven key components, by the decision-makers based on the outranking relationships. Network maps encompass the selected PIs using the decision-makers’ boundary and leave a choice for including additional PIs in future for continuous performance improvement. A conceptual performance assessment framework has also been proposed for practical implementation of the selected PIs for MSWM systems in KSA and other parts of Gulf region with similar conditions.