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At present, there are many environmental, economic and social problems associated with poor municipal solid waste (MSW) management in Thailand. The development of sustainable solid waste management systems is a crucial aspect and should be based on an integrated approach. Therefore, an integrated system was designed for Nonthaburi Municipality incorporating recycling, anaerobic digestion, incineration and landfill technologies. In order to assess sustainability, a clear methodology was developed via life cycle thinking and a set of endpoint composite indicators has been proposed considering the most critical ultimate damages/effects of MSW management on the environment, the economy and society. The results showed that the appropriate integration of technologies offers important prospects with regards to socio-economic and environmental aspects, contributing, therefore, to improved sustainability for the overall MSW management system. The methodology and the proposed indicators would be useful in strategic planning, including decision- and policy-making with respect to the development of appropriate sustainable MSW management systems.