Various decision support methods are used to support the sustainable use of natural resources, but there is little evidence about these methods' actual performances. In this study, 35 carefully selected papers assessing the sustainable use of natural resources were evaluated. The evaluated papers utilized one of the following methods: optimization, costbenefit analysis (CBA) and monetary valuation methods, multi-criteria decision analysis (MCDA) or hybrid approaches. Each method supported sustainability in a different manner. Optimization and CBA case studies rarely involved stakeholders and social sustainability was less processed. Monetary valuation case studies showed a regular participation of the general public, but in a passive role. Experts and stakeholders with an active role were typical participants in MCDA and hybrid case studies. Internationally and nationally defined indicators of sustainability were scarcely used because indicators were frequently defined by stakeholders or the authors of the studied papers. It was presumed that international and national indicators were unsuitable for local use. Sustainability indicators typically took both the quantitative and qualitative form, including gaps and uncertainties. MCDA could be a suitable method for assessing sustainability because it has no strict requirements on the form of the data, and the participation of stakeholders is comprehensive. For the problem structuring phase, however, MCDA might not provide efficient tools. The ideal method for assessing the sustainable use of natural resources could be a hybrid of two methods with different approaches: qualitative methods could be used in the problem structuring process, whereas quantitative methods could be used when priorities and thresholds are assessed.