The management of sewage sludge originated from municipal wastewater treatment plants (WWTPs) is an urgent issue. In 2019, the local authority of the Piemonte region started a survey with the aim of collecting recent data concerning wastewater and sludge management in the WWTPs located in its own territory. The survey’s results revealed that 60% of the sludge (51,000 t, as dry substance, d.s.) produced by the local WWTPs was recovered or disposed of outside of the region, and a similar amount of sludge was recovered in agriculture directly or after composting. The increase in the costs to accommodate sewage sludge in recovery or disposal plants, followed to a recent Italian Sentence (27958/2017), and the more and more stringent requirements fixed by lots of European countries for the application of sludge in agriculture, are pushing the Piemonte region authority to re-organize its own network for sludge management, with solutions based onto proximity and diversification. Whether the provisions of the current German legislation are applied in the future also in Italy, approx. 90% of sewage sludge produced into the Piemonte region should be incinerated, with a subsequent step of phosphorous recovery. The new regional plan, according to the Regional Address Deed, should consider a diversification of sludge treatment and recovery practices. On this basis, a need for new plants for around 40,000 t d.s./y could be planned.