Metal and tributyltin (TBT) contaminated sediments are problematic for sediment managers and the environment. This study is the first to compare Fenton’s reagent and electrochemical treatment as remediation methods for the removal of TBT and metals using laboratory-scale experiments on contaminated dredged sediment. The costs and the applicability of the developed methods were also compared and discussed. Both methods removed > 98% TBT from TBT-spiked sediment samples, while Fenton’s reagent removed 64% of the TBT and electrolysis 58% of the TBT from non-spiked samples. TBT in water phase was effectively degraded in both experiments on spiked water and in leachates during the treatment of the sediment. Positive correlations were observed between TBT removal and the added amount of hydrogen peroxide and current density. Both methods removed metals from the sediment, but Fenton’s reagent was identified as the most potent option for effective removal of both metals and TBT, especially from highly metal-contaminated sediment. However, due to risks associated with the required chemicals and low pH level in the sediment residue following the Fenton treatment, electrochemical treatment could be a more sustainable option for treating larger quantities of contaminated sediment.