Fire and explosion accidents of oil-filled electrical transformers are leading to negative impacts, not only on the delivery of energy, but also on workplace health and safety as well as the surrounding environment. Such accidents are still being reported, regardless of applying the regular maintenance strategy in the power plants. The purpose of this paper is to integrate a sustainability perspective into the maintenance strategy. The problem addressed is: how can we approach the relevant cost-effective sustainable maintenance for oil-filled electrical transformers? For this purpose, an empirical study in a power plant in Kuwait was introduced. The first stage was to carry out a sustainability assessment using the ABCD procedure. In this procedure, gaps to approach sustainability were identified and actions prioritized to close these gaps were demonstrated. Applying this procedure yielded an early fault diagnosis (EFD) model for achieving cost-effective sustainable maintenance using a fault trend chart based on a novel numerical method. Implementing this model resulted in an extension of the lifetime of transformers with suspected failure propagation, leading to a deferral of the replacement investment costs. The principal conclusion of this paper is the importance of viewing the maintenance strategy of transformers from a strategic sustainability perspective, in order to approach relevant cost-effective sustainable maintenance.