Hydrothermal carbonization (HTC) of sewage sludge reduces the waste volume and can be source of energy and valuable products. Furthermore, HTC offers several advantages over conventional dry-thermal pre-treatments, as no prior drying is requested, and the high quality of the char produced promotes applications as energy production and storage, wastewater remediation, and soil amendment. Relationships between char yields, physicochemical properties and process parameters are here analysed, with the aim to provide insight into the choice of the process severity required to fit the desired application. Moreover, presence and fate of heavy metals and organic contaminants are discussed. The highest reaction temperature is the main parameter affecting the physicochemical characteristics of the char produced, while the heating rate governs the heat mass transfer and the rate of intermediates formation. Depolymerization of the biomass results in a reduction of the oxygen to carbon ratio and, therefore, in augmented high heating values, further increased by deposition of 5-(hydroxymethyl)furfural. Recirculation of process water may enhance dehydration reactions and the deposition of degraded polymers, increasing dewaterability and yield, but field trials are recommended to assess the feasibility of this option. An overuse of chars for energy generation purposes would be deleterious for the environmental life cycle. Further research is encouraged to assess the pollutants abatement and their degradation pathways when incorporated in the carbonaceous product, to promote the application of hydrochars as soil amendment, as well as for environmental remediation purposes.