Flow chemistry has changed chemical process designs toward process intensification and is generally considered as green methodology. In this connection, this perspective provides a more critical and holistic view about the sustainability of flow chemistry by introducing both simple and complex holistic tools for environmental quantitative assessment on sustainability and providing examples of how they were used for flow chemistry. The latter also shows a critical assessment of what flow chemistry can add to make chemical processes more sustainable. With the increasing complexity of assessment, green chemistry metrics, life cycle assessment methodology, and circular transition indicators are discussed. In this way, the sustainability of flow chemistry is assessed first on the level of a reaction only and then moving to a process level and beyond. Flow chemists are very aware of the principles of green chemistry and their simple metrics. Yet, they hardly use life cycle assessment, and quantitative circularity analysis has not been made. When those assessments are used, it is usually done by researchers with an ecology background. This perspective aims to make flow chemists aware of the opportunities that complex environmental assessment can provide and that protecting our planet requires a holistic sustainability consideration. The perspective critically states what each of the three types of assessments can do and what their limitations are.