Improving equipment effectiveness is crucial for flexible manufacturing, ensuring that machines and tools perform their functions efficiently and consistently. Our study aimed to enhance the Overall Equipment Effectiveness (OEE) in Bangladesh’s Ready-Made Garments (RMG) manufacturing system. We used the DMADV methodology incorporating Visual Stream Mapping (VSM) and OEE. By utilising VSM, we identified issues, eliminated them in the design phase, and evaluated performance in the verification phase. We automated the material handling system to reduce handling time, and the result was a significantly improved OEE in the automated manufacturing system compared to the manual one. This study has numerous benefits in flexible manufacturing and operations management, from immediate efficiency improvements to long-lasting organisational cultural transformations. Thus, it’s a noteworthy topic for practical applications and research. Enhancing Equipment Effectiveness through Visual Stream Mapping 4.0 has broad-reaching implications, including improved productivity, reduced waste, increased efficiency, better resource utilisation, and a more agile and responsive manufacturing environment. Although OEE and VSM are frequently used separately in different manufacturing systems, this study’s novelty lies in their combined application within garment manufacturing.