The Italian shellfish industry mainly comprises clams, mussels, and oysters. While clam production thrives and Italy leads Europe, mussel farming faces economic challenges. Oyster production is relatively new and holds potential. Sustainable development is crucial for meeting growing seafood demand while ensuring resource conservation and food safety. This paper, part of the VALUE-SHELL project funded by the Italian Ministry of Agriculture, Food Sovereignty and Forests (MASAF) as part of support activities for the National Strategic Plan of Aquaculture, combines desk research on industry structure and public interventions using a collaborative approach involving stakeholder interviews and focus groups with producers and local entities to assess the sector’s most compelling needs. The collaborative process highlighted key challenges across the following four sustainability pillars: environmental (global warming, predator control, and pollution mitigation are critical concerns for ecosystem balance); economic (increased production costs and limited diversification opportunities affect profitability); social (fear of generational decline due to limited training and education opportunities poses a threat to the industry’s future); and institutional (lack of a dedicated aquaculture law and fragmented governance hinder long-term planning). The project identifies policy bottlenecks hindering the sector’s potential, caused by not fully addressing producer needs. Sustainable development strategies are essential for addressing these challenges and ensuring the Italian shellfish industry’s future.