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This study aims to analyse the efficiency of public higher education institutions (HEIs) through teaching and learning (T&L), research and technology (R&T) and social responsibility (SR) activities. It also aims to assess the external factors influencing the efficiency of T&L, R&T and SR, and influence of this efficiency on sustainable regional economic growth and innovation intensity.

The empirical approach is based on a two-step data envelopment analysis to compare the efficiency of 23 Portuguese public HEIs, using a Tobit regression, to assess the influence of the factors affecting HEI efficiency which in turn affects regional sustainability and innovation.

The results lead to the following conclusions: HEIs with better SR efficiency are situated in large urban centres; an insular location is positively associated with HEIs’ T&L and SR efficiency; HEIs’ T&L and SR efficiency positively influence regional gross domestic product (GDP); and HEIs’ R&T efficiency positively influences R&D in regional GDP.

This study offers implications in the domain of sustainable regional growth. The study recommends that the policies of HEIs should concentrate on developing activities that meet the needs of the region. It also emphasizes the need to invest in recruitment of qualified lecturers and researchers, and creation of relevant PhD positions. The study also emphasizes the need for government actions to consider the most disadvantaged regions and create infrastructure to attract new companies and people.

This study contributes to the existing literature on the efficiency of HEIs by considering the efficiency of not only T&L and R&T but also SR. It also analyses the influencers of both HEIs’ efficiency and regional development.