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In this article, 35 published studies on life cycle assessment (LCA) of sewage sludge were reviewed for their methodological and technological assumptions. Overall, LCA has been providing a flexible framework to quantify environmental impacts of wastewater and sewage sludge treatment and disposal processes for multiple scales, ranging from process selection to policy evaluation. The results of LCA are, in principle, unique to the goal and scope of each study, reflecting its local conditions and comparison between different LCAs is not intended. Furthermore, the assessments are limited by the methodological development of the life cycle impact assessment (LCIA) and the advancement of research in quantifying environmental emissions associated with wastewater and sewage sludge treatment processes. Thus, large discrepancies were found in the selection of the environmental emissions to be included and how they were estimated in the analysis. In order to reduce these choice uncertainties, consolidation of the modelling approach in the following area are recommended: quantification of fugitive gas emissions and modelling of disposal practices. Besides harmonization of the key technical assumptions, clear documentation of the modelling approach and the uncertainties associating with each assumption is encouraged so as to improve the integrity and robustness of assessment.