Over the last few decades, process industries have invested increasing efforts in developing technical and operating solutions related to industrial symbiosis and energy efficiency in both production processes and auxiliary services. In particular, new technologies that enable industrial symbiosis, such as novel treatment processes for byproduct extraction and valorization, water purification, and energy transformation, were implemented in different sectors. This work analyses recent relevant results in the implementation of industrial symbiosis and energy efficiency solutions within process industries across Europe, based on the transactions of energy and material flows. Current developments, based on the circular economy’s transformation levers and related achieved results, were taken into account by considering the achieved results coming from the literature, EU-funded projects, programmes, and initiatives on the implementation of technical solutions and practices related to industrial symbiosis and energy efficiency. In addition, the most relevant challenges deriving from the implementations of industrial symbiosis and energy efficiency were analysed. A comprehensive picture of the sectors involved in achieving more proactive cross-sectorial cooperation and integration was provided, as well as an analysis of the main drivers and barriers for IS and EE implementation in future scenarios for European process industries.