Anaerobic digestion is a well-known technology with wide application in the treatment of high-strength organic wastes. The economic feasibility of this type of installation is usually attained thanks to the availability of fiscal incentives. In this review, an analysis of the different factors associated with this biological treatment and a description of alternatives available in literature for increasing performance of the process were provided. The possible integration of this process into a biorefinery as a way for producing energy and chemical products from the conversion of wastes and biomass also analyzed. The future outlook of anaerobic digestion will be closely linked to circular economy principles. Therefore, this technology should be properly integrated into any production system where energy can be recovered from organics. Digestion can play a major role in any transformation process where by-products need further stabilization or it can be the central core of any waste treatment process, modifying the current scheme by a concatenation of several activities with the aim of increasing the efficiency of the conversion. Thus, current plants dedicated to the treatment of wastewaters, animal manures, or food wastes can become specialized centers for producing bio-energy and green chemicals. However, high installation costs, feedstock dispersion and market distortions were recognized as the main parameters negatively affecting these alternatives.