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The European Union (EU) has introduced a range of policies to promote energy efficiency, including setting specific targets for energy-efficient renovations across the EU building stock. This study provides a comprehensive environmental and economic assessment of energy-efficient renovation scenarios in a large-scale multifamily building project that is district-heated, considering both the building and the broader urban energy system. A systematic framework was developed for this assessment and applied to a real case in Sweden, where emission factors from energy production are significantly lower than the EU average: 114 g CO2e/kWh for district heating and 37 g CO2e/kWh for electricity. The project involved the renovation of four similar district-heated multifamily buildings with comparable energy efficiency measures. The primary distinction between the measures lies in the type of HVAC system installed: (1) exhaust ventilation with air pressure control, (2) mechanical ventilation with heat recovery, (3) exhaust ventilation with an exhaust air heat pump, and (4) exhaust ventilation with an exhaust air heat pump combined with photovoltaic (PV) panels. The study’s findings show that the building with an exhaust air heat pump which operates intermittently with PV panels achieves the best environmental performance from both perspectives. A key challenge identified for future research is balancing the reduced electricity production from Combined Heat and Power (CHP) plants within the energy system.