The turbulent business environment of today poses research questions about our understanding of the processes at play regarding achieving competitive advantage through sustainable innovation performance. “Total quality management (TQM)” is known to provide improvement in all business processes including innovation, but how do these interact with the requirements of an uncertain environment is unclear. We examine the role of an organization’s strategic alignment in the relationship between TQM practices and innovation performance. Four TQM practices were selected from the “Malcolm Baldrige National Quality Award” model; “customer focus, human resource management, continuous improvement and leadership” and their relationship was tested with strategic alignment and innovation performance. Analysis of data from 357 respondents working in service organizations in the Sultanate of Oman, showed that TQM practices have a significant and positive impact on strategic alignment, and strategic alignment partially mediates the relationship between TQM practices and innovation performance. This study uncovers interesting findings about the influence of TQM practices on organizational strategic alignment and how that in turn impacts the product, process, and administrative innovation performance. The findings inform managers looking for enhanced innovation performance in the current uncertain business environment about the important role of TQM practices.