In this study, the wave propagation properties of piezoelectric sandwich nanoplates deposited on an orthotropic viscoelastic foundation are analyzed by considering the surface effects (SEs). The nanoplates are composed of a composite layer reinforced by graphene and two piezoelectric surface layers. Utilizing the modified Halpin-Tsai model, the material parameters of composite layers are obtained. The displacement field is determined by the sinusoidal shear deformation theory (SSDT). The Euler-Lagrange equation is derived by employing Hamilton’s principle and the constitutive equations of piezoelectric layers considering the SEs. Subsequently, the nonlocal strain gradient theory (NSGT) is used to obtain the equations of motion. Next, the effects of scale parameters, graphene distribution, orthotropic viscoelastic foundation, and SEs on the propagation behavior are numerically examined. The results reveal that the wave frequency is a periodic function of the orthotropic angle. Furthermore, the wave frequency increases with the increase in the SEs.