Gas evolution and flow patterns inside an alkaline electrolyzer cell strongly affect efficiency, although such effects have not been explored in detail to date. The present study aims to critically analyze the dependence of cell performance on the multiphase flow phenomena, defining some key metrics for its assessment using CFD. Six performance indicators, involving gas accumulation, bubble coverage, and flow uniformity, are applied to a 3D CFD model of an alkaline cathodic cell, and possible optimizations of the cell geometry are evaluated. The results demonstrate the complexity of defining the optimal indicator, which strictly depends on the case study and on the analysis at hand. For the cell analyzed herein, the parameters linked to the electrode volume fraction were indicated as the most influential on the cell efficiency, allowing us to define the best geometry case during the optimization. Furthermore, a sensitivity analysis was conducted, which showed that higher mass flow rates are generally preferable as they are linked to higher bubble removal. Higher current densities, allowing enhanced gas production, are instead associated with slightly lower efficiencies and stronger nonuniformity of the electrolyte flow inside the cell.