In the context of climate policies that advocate carbon neutrality, carbon emission reduction provides a new restriction in evaluating the waste activated sludge (WAS) treatment technologies and procedures. This review provides an overview of current researches and development efforts in WAS treatment, focusing on the dual attributes of WAS as contaminants and resources. Firstly, the improved technical requirements posed by heavy metals, micro(nano) plastics, or other emerging plastics in WAS are studied. Furthermore, in terms of carbon emission reduction, the applications and limitations of widely deployed WAS treatment technologies are discussed. Based on carbon neutrality requirements, the anaerobic co-digestion and co-pyrolysis technologies are comprehensively discussed from the views of pollutants removing efficiencies, enhancement methods, carbon emissions, and resource recovery. Finally, a workable new route for WAS treatment is proposed for future technological advancement and engineering innovation.