In this work, different alternatives to conventional tertiary treatment of pulp and paper (P&P) wastewater (WW), i.e., physicochemical coagulation-flocculation, were investigated to enhance the environmental and economic sustainability of industrial wastewater treatment. In particular, following a preliminary characterization of secondary effluents, cloth filtration and adsorption were studied, the former by pilot-scale tests, while the latter at laboratory scale. An economic analysis was finally accomplished to verify the full-scale applicability of the most promising technologies. Cloth filtration showed excellent total suspended solids (TSS) removal efficiency (mean 81% removal) but a very limited influence on chemical oxygen demand (COD) (mean 10% removal) due to the prevalence of soluble COD on particulate COD. Adsorption, instead, led to a good COD removal efficiency (50% abatement at powdered activated carbon—PAC—dosage of 400 mg/L). The economic analysis proved that adsorption would be convenient only if a local low-cost (100 €/ton) adsorbent supply chain was established. Ultrafiltration was considered as well as a potential alternative: its huge capital cost (19 M€) could be recovered in a relatively short timeframe (pay-back time of 4.7 years) if the ultrafiltrated effluent could be sold to local industries.