This paper describes the state of the art and future opportunities for process design and sustainable development. In the Introduction, the main global megatrends and the European Union’s response to two of them, the European Green Deal, are presented. The organization of professionals in the field, their conferences, and their publications support the two topics. A brief analysis of the published documents in the two most popular databases shows that the environmental dimension predominates, followed by the economic one, while the social pillar of sustainable development is undervalued. The main design tools for sustainability are described. As an important practical case, the European chemical and process industries are analyzed, and their achievements in sustainable development are highlighted; in particular, their strategies are presented in more detail. The conclusions cover the most urgent future development areas of (i) process industries and carbon capture with utilization or storage; (ii) process analysis, simulation, synthesis, and optimization tools, and (iii) zero waste, circular economy, and resource efficiency. While these developments are essential, more profound changes will be needed in the coming decades, such as shifting away from growth with changes in habits, lifestyles, and business models. Lifelong education for sustainable development will play a very important role in the growth of democracy and happiness instead of consumerism and neoliberalism.