Interstage mass balance analyses were performed to assess the fate of 15 PFAS in two full-scale wastewater sludgehandling systems. Both systems consisted of thickening (rotary drum, gravity, and dissolved air flotation), anaerobic digestion, and dewatering, while one of them also included primary sludge fermentation. On a mass concentration basis, PFOS was the most abundant compound in both systems, with concentrations as high as 12.9 μg/kg and 53 ng/L in solid and liquid samples, respectively. On a molar basis, PFOS was the most abundant compound in solid samples (up to ∼26,000 picomol/kg), while PFBA was the most abundant compound in liquid samples (up to 140 picomol/L). Fermentation (a sludge retention time of 4 days) did not cause a significant change in PFAS mass flows. In contrast, anaerobic digestion (sludge retention times of 45 and 20 days) resulted in mass flow increases for 12 PFAAs and mass flow decreases for three precursors. Precursor transformation and PFAA formation increased with the sludge retention time of the digesters. In the liquid−solid separation processes (thickening and dewatering), PFAS with carbon chain lengths of