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This study focuses on a comprehensive sustainability assessment of the management of the organic fraction of municipal solid waste in Ghent (Belgium), Hamburg (Germany) and Pécs (Hungary). A sustainability assessment framework has been applied to analyse social, environmental, and economic consequences at the midpoint level (25 impact categories) and at the endpoint level (5 areas-of-protection). For each case study, the reference scenario was analysed, along with three solutions to improve the sustainability performance, which were selected and developed with the collaboration of local stakeholders. The solutions focus on food waste prevention, collection (increasing separate collection and household composting) and/or valorisation treatment (insect breeding, bioplastic production and improvement of centralised treatment). The results show that food waste prevention results in substantial improvements in all areas of protection when a significant quantity of food is saved. Solutions proposing innovative treatments such as insect breeding do not show clear improvements at the endpoint level, given current technology development level, but appear promising for some categories such as Revenues, Ecotoxicity, Land Use or Particulate Matter if the substituted products compensate the impact of the treatment (e.g., energy and water use). Enhancing the separate collection of organic waste can improve sustainability, but trade-offs may arise, e.g., decreased environmental savings from energy recovery at incineration. For this, the influence of the electricity mix (more or less decarbonised) should be carefully considered in future studies. The application of the solutions proposed to other cities should also consider potential bottlenecks such as legislation barriers, public acceptance, or management costs., (Copyright © 2021 Elsevier Ltd. All rights reserved.)