Sediments in ports, marinas and waterways around the world are often contaminated with metals arising from anthropogenic activities. Regular dredging is needed to achieve an appropriate water depth and reduce the environmental impact of pollutants. The aim of this study was to develop an integrated assessment method for comparing various management strategies for dredged sediments at six case study sites in Sweden. Short- and long-term environmental impacts were investigated for different management approaches, including landfilling, deep-sea disposal, metal extraction in combination with the two aforementioned, and natural recovery (no dredging). The potential value of metals in the sediments was estimated using sediment metal contents and current metal prices. Additionally, an assessment of how metal extraction could result in lower management costs was carried out. The cost of the different management approaches was calculated and evaluated together with the corresponding environmental impacts. This study shows that there is a monetary value in dredged materials, in terms of metal content, and that the materials can potentially be used for metal extraction. Metal extraction may also help to reduce the management costs, as cleaner materials are cheaper to handle. The choice of metal recovery method is important in both monetary and environmental terms, potentially contributing to a circular economy. In the future, metal recovery may become more profitable, as technologies are improved, and due to probable increases in metal prices and landfill costs.