This paper reports the main outcome of research to compare and assess the merits of alternative strategies for energy recovery from municipal solid waste downstream of material recovery for an Italian province. Strategies analysed are based on well-established combustion technologies available at the commercial scale in the Italian market in comparison with an innovative but not yet proven option of refuse derived fuel gasification and subsequent co-combustion of syngas in a combined cycle power plant. The comparison is made using mass and energy balances, environmental assessment and economic analysis. From an energetic point of view, the best strategy is the one based on the refuse derived fuel gasification, which, on the contrary, does not show interesting environmental results. In this perspective, the best results are from strategies based on a dedicated plant, particularly when unsorted residual waste collected downstream of material recovery is used. Finally, from an economic point of view, the strategy with gasification allows the highest revenues from the sale of energy.