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Sewage sludge management poses environmental, economic, and political challenges for wastewater treatment plants and municipalities around the globe. To facilitate more informed and sustainable decision making, this study used life-cycle inventory (LCI) to expand upon previous process-based LCIs of sewage sludge treatmenttechnologies. Additionally, the study evaluated an array of productive end-use options for treated sewage sludge, such as fertilizer and as an input into construction materials, to determine how the sustainability of traditional manufacturing processes changes with sludge as a replacement for other raw inputs. The inclusion of the life-cycle of necessary inputs (such as lime) used in sludge treatment significantly impacts the sustainability profiles of different treatment and end-use schemes. Overall, anaerobic digestion is generally the optimal treatment technology whereas incineration, particularly if coal-fired, is the most environmentally and economically costly. With respect to sludge end use, offsets are greatest for the use of sludge as fertilizer, but all of the productive uses of sludge can improve the sustainability of conventional manufacturing practices. The results are intended to help inform and guide decisions about sludge handling for existing wastewater treatment plants and those that are still in the planning phase in cities around the world. Although additional factors must be considered when selecting a sludge treatment and end-use scheme, this study highlights how a systems approach to planning can contribute significantly to improving overall environmental sustainability.