The increasing levels of sewage sludge production demands research and development to introduce more commercially feasible options for reducing socio-economic and environmental problems associated with its current treatment. Sewage sludge may be processed to produce useful products or as a feedstock for energy generation. Initially, the characteristics of sewage sludge are discussed in terms of composition and the current options for its treatment with the associated environmental impacts. Processes to valorize sewage sludge are discussed, including heavy metal removal from sewage sludge, production of bio-char, production and use of activated carbon and use of sewage sludge combustion ash in cement and concrete. Thermochemical processes i.e., pyrolysis, co-pyrolysis and catalytic pyrolysis, also gasification and combustion for process intensification, energy and resource recovery from sewage sludge are then critically reviewed in detail. The pyrolysis of sewage sludge to produce a bio-oil is covered in relation to product bio-oil composition, reactor type and the use of catalysts. Gasification of sewage sludge focusses on the characteristics of the different available reactor types and the influence of a range of process parameters and catalysts on gas yield and composition. The selection and design of catalysts are of vital importance to enhance the selectivity of the selected thermochemical pyrolysis or gasification process. The catalysts used for sewage sludge treatment need more research to enable selectivity towards the targeted desired end-products along with optimization of parametric conditions and development of innovative reactor technologies. The combustion of sewage sludge is reviewed in terms of reactor technologies, flue gas cleaning systems and pollutant emissions. In addition, reactor technologies in terms of technological strength and market competitiveness with the particular application to sewage sludge are compared for the first time for thermochemical conversion. A critical comparison is mad...