A study was performed based on the design of a new wastewater treatment plant (WWTP) to be built in Weesp, The Netherlands (about 46,000 Population Equivalents (PE)). The conventional activated sludge plant was considered among the alternatives, with and without primary sedimentation. This pre-treatment technique is considered a sustainability measure as it improves the energy balance of the WWTP. However, at the same time, the question arose about the cost effectiveness of this measure. The scope of the study was to assess whether other sustainability measures (like solar panels) can realise the same level of sustainability with lower costs. The outcome of the study indeed shows that, for a new WWTP, it is considerably cheaper to avoid primary sedimentation and focus on other measures like solar panels instead. This appeared not only to be the case for the scale of WWTP Weesp, but also for WWTPs with capacities higher than 500,000 PE. For existing WWTPs with primary sedimentation, the choice can be different as customisation is necessary.