An analysis of energy and material flows has been elaborated for the Swedish region Jämtland with the aim of monitoring and comparing regional sustainability by following the work energy flow method developed in a study of the Danish island of Samsø (Nielsen & Jørgensen, 2011).In the region of Jämtland about 46,000 TJ of energy flows into society, of which 88% is renewable. From this an amount corresponding to 30,800 TJ is exported as electricity from the region, while another 410 TJ is exported as waste to be incinerated. The remaining part, about 15,200 TJ (63% renewable), drives Jämtland. From an energy flow perspective, the most important production from the region, apart from electricity production, is biomass from the forest: 49,000 TJ estimated as energy content in the biomass harvested. Another 55,000 TJ is added to the standing biomass every year as forest growth (only productive forest land area has been calculated).Some suggested indices of sustainability have been calculated and Jämtland shows high values. However, it will be a challenge to transform the quite large transport sector of Jämtland, and therefore the potential to become fully sustainable (ref to indexes used for the Samsø study) might not be quite as high. In order to reduce the use of non-renewable energy, a major conversion of the transport fleet is needed, and this should be given high priority. The private sector is the largest single user of non-renewable energy (2,200 TJ). One successful transition is the Swedish diesel mix with 19% FAME/HVO derived from vegetable or animal sources and regarded as renewable. The consumption of FAME/HVO is predicted to increase significantly, increasing the importance of the forest as a source.A sustainability analysis based at work energy flows shows for both Samsø and Jämtland that large natural resources producing a high work energy output combined with low work energy use due to low population density, gives high sustainability indicators. This indicates that regions with high population density and the absence of natural resources (high import), as in most regions in the world, will show low sustainability indicators.