Sludge or waste activated sludge (WAS) generated from wastewater treatment plants may be considered a nuisance. It is a key source for secondary environmental contamination on account of the presence of diverse pollutants (polycyclic aromatic hydrocarbons, dioxins, furans, heavy metals, etc.). Innovative and cost-effective sludge treatment pathways are a prerequisite for the safe and environment-friendly disposal of WAS. This article delivers an assessment of the leading disposal (volume reduction) and energy recovery routes such as anaerobic digestion, incineration, pyrolysis, gasification and enhanced digestion using microbial fuel cell along with their comparative evaluation, to measure their suitability for different sludge compositions and resources availability. Furthermore, the authors shed light on the bio-refinery and resource recovery approaches to extract value added products and nutrients from WAS, and control options for metal elements and micro-pollutants in sewage sludge. Recovery of enzymes, bio-plastics, bio-pesticides, proteins and phosphorus are discussed as a means to visualize sludge as a potential opportunity instead of a nuisance.