This paper analyses four strategies for managing the Mixed Municipal Solid Waste (MMSW) in terms of their environmental impacts and potential advantages by means of Life Cycle Assessment (LCA) methodology. To this aim, both a multi-input and a multi-output approach are applied to evaluate the effect of these perspectives on selected impact categories. The analyzed management options include direct landfilling with energy recovery (S-1), Mechanical-Biological Treatment (MBT) followed by Waste-to-Energy (WtE) conversion (S-2), a combination of an innovative MBT/MARSS (Material Advanced Recovery Sustainable Systems) process and landfill disposal (S-3), and finally a combination of the MBT/MARSS process with WtE conversion (S-4). The MARSS technology, developed within an European LIFE PLUS framework and currently implemented at pilot plant scale, is an innovative MBT plant having the main goal to yield a Renewable Refined Biomass Fuel (RRBF) to be used for combined heat and power production (CHP) under the regulations enforced for biomass-based plants instead of Waste-to-Energy systems, for increased environmental performance. The four scenarios are characterized by different resource investment for plant and infrastructure construction and different quantities of matter, heat and electricity recovery and recycling. Results, calculated per unit mass of waste treated and per unit exergy delivered, under both multi-input and multi-output LCA perspectives, point out improved performance for scenarios characterized by increased matter and energy recovery. Although none of the investigated scenarios is capable to provide the best performance in all the analyzed impact categories, the scenario S-4 shows the best LCA results in the human toxicity and freshwater eutrophication categories, i.e. the ones with highest impacts in all waste management processes.