The amount of waste activated sludge (WAS) is increasing annually, and since it presents potential environmental and health-related risks, an appropriate treatment and stabilization process is needed. It has been shown in numerous studies in the past few decades that amongst the advanced treatment methods of sludge, microwave and ultrasound-based processes offer promising and effective alternatives. The main advantage of these physical methods is that they are energy-efficient, easy to implement and can be combined with other types of treatment procedures without major difficulties. In this review article we would like to present the recent scientific results of the microwave, ultrasound and combined (microwave-alkaline, microwave-H2O2, ultrasound-alkaline and ultrasound-H2O2) treatment of wastewater sludge, in terms of different process-efficiency indicators. Although the obtained results somewhat vary between the different scientific papers, it can be undoubtedly stated that both MW and US—either individually or in combination with chemical treatments—can enhance several aspects of sludge processing, like increasing the SCOD/TCOD rate, disintegration degree (DD), or the anaerobic digestibility (AD), but the extent of these increments clearly depends on the treatment conditions or parameters.