Italy has been defined as the “logistics platform” of the Mediterranean Sea. The Italian port system, with 11.6 million TEUs handled and 61.4 million passengers in 2022 (Assoporti data January–December 2022), is the key to fulfilling this title through adequate levels of reliability, safety, and sustainability. This contribution addresses port logistics and shipping, focusing on primary issues related to the energy sector with a specific focus on what can be observed in the Italian context. Specifically, the decarbonization of the maritime sector and related infrastructural problems (e.g., cold ironing or alternative fuels, where the uncertainty about resource availability and related costs do not allow for easy strategic planning by both the ship owner and the port authority), as well as policies such as the Emission Trading System (ETS), will be analyzed. All these issues, hereafter addressed with a systematic critical review of the existing literature and other relevant sources, could represent the driving force of the growth of the national port sector toward its competitiveness at a global scale. The review was performed through a wide search and analysis of studies published in well-known online research databases (Scopus, Web of Science, IEEE Xplore, ScienceDirect), sector studies, or specialized technical magazines. The review focuses on the results of each analyzed contribution rather than on the analysis method adopted with the final aim to identify useful hints and innovative ideas for further studies on the topic.