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Sustainable remediation has come to exist as a popular term used to describe contaminated site management that is demonstrably sustainable, i.e. where some form of sustainability appraisal has been used in decision making to identify the “most sustainable” approach for any particular management intervention required. The “most sustainable” approach is one that, in the view of the stakeholders involved in making or considering management decisions, has the optimal balance of effects and benefits across the three elements of sustainability: environment, economy and society. This chapter describes how the Brundtland Report concept of sustainable development can be linked with contaminated site remediation practice, both how sustainability can be assessed and used as a tool in decision making; and also how sustainability thinking is creating new contaminated site remediation approaches, for example, marrying concepts of Risk Management and renewable energy production. The chapter discusses the individual “indicators” or metrics that contribute to an understanding of sustainability, the tools available for combining these into a sustainability appraisal, and the types of boundary conditions that need to be considered in setting the scope of sustainability appraisal. The chapter also discusses the linkage of “sustainability” with “Risk Management”, the importance of engaging stakeholders in sustainability appraisal, and an emerging set of international initiatives in the field. Finally it presents a series of sustainable remediation case studies (technologies and decision making tools) and a view of the possible future for “sustainable remediation”.