The enormous magnitude and variety of microwave applications in household, commercial and industrial food processing creates a strong motivation for improving the energy efficiency and hence, sustainability of the process. This review critically assesses key energy issues associated with microwave food processing, focusing on previous energy performance studies, energy performance metrics, standards and regulations. Factors affecting energy-efficiency are categorised into source, load and source-load matching factors. This highlights the need for highly-flexible and controllable power sources capable of receiving real-time feedback on load properties, and effecting rapid control actions to minimise reflections, heating non-uniformities and other imperfections that lead to energy losses. A case is made for the use of solid-state amplifiers as alternatives to conventional power sources, magnetrons. By a full-scale techno-economic analysis, including energy aspects, it is shown that the use of solid-state amplifiers as replacements to magnetrons is promising, not only from an energy and overall technical perspective, but also in terms of economics.