The high investment cost required by modern treatment technologies of hazardous sewage sludge such as incineration and anaerobic digestion have discouraged their application by many developing countries. Hence, this review elucidates the status, performances and limitations of two low-cost methods for biological treatment of hazardous sewage sludge, employing vermicomposting and black soldier fly larvae (BSFL). Their performances in terms of carbon recovery, nitrogen recovery, mass reduction, pathogen destruction and heavy metal stabilization were assessed alongside with the mature anaerobic digestion method. It was revealed that vermicomposting and BSFL were on par with anaerobic digestion for carbon recovery, nitrogen recovery and mass reduction. Thermophilic anaerobic digestion was found superior in pathogen destruction because of its high operational temperature. Anaerobic digestion also had proven its ability to stabilize heavy metals, but no conclusive finding could confirm similar application from vermicomposting or BSFL treatment. However, the addition of co-substrates or biochar during vermicomposting or BSFL treatment may show synergistic effects in stabilizing heavy metals as demonstrated by anaerobic digestion. Moreover, vermicomposting and BSFL valorization had manifested their potentialities as the low-cost alternatives for treating hazardous sewage sludge, whilst producing value-added feedstock for biochemical industries. © 2021 Elsevier B.V.