The vibro-acoustic performance of a sandwich plate with periodic locally resonant (LR) units is examined in this paper, with specific focus on the effect of periodic resonators on the average radiation efficiency and the acoustic radiation to the far field. In order to assess the radiation performance, the band-gap properties of an infinite periodic structure and the vibrational response of a finite periodic structure are first studied with closed-form solutions. Subsequently, the acoustic radiation efficiency of the LR sandwich plate is obtained using the concepts of modal radiation. It is shown that the acoustic radiation power can be reduced significantly, not only in the band-gap but also at frequencies close below the band-gap, due to either the decrease in radiation efficiency or the decrease in the vibration response. Thus, the periodic resonators provide a broader attenuation band for the purposes of noise reduction than for vibration reduction. However, for frequencies close above the band-gap, the acoustic performance became worse, owing to the increase in acoustic radiation efficiency. Fortunately, the increased sound radiation above the band-gap can be reduced by adding a small damping to the resonator, which further broadens the attenuation frequency band. The reason for the variation of acoustic radiation efficiency is also studied and can be physically explained by the effective mass of an LR unit, where increased mass corresponds to decreased radiation efficiency and decreased mass corresponds to increased radiation efficiency. Thus, the effective mass can be a useful parameter for designers to estimate which frequency component will be acoustically reduced or acoustically enhanced in a practical design.