The multi-utility tunnel has received increased attention as an alternative method for the installation of subsurface infrastructure for the distribution of electricity, water, sewage and district heating. In previous research, the multi-utility tunnel (MUT) has been described as a more sustainable technology compared to the conventionally used technique where the cables and pipes are placed with open-cut excavation (OCE), especially when the entire life cycle is taken into account. This thesis aims to contribute to an improved understanding of MUT's sustainability performance in relation to conventional installation using open-cut excavation. This is done by using literature study, interview study and quantitative sustainability assessments to gain an understanding of the current state of knowledge. Furthermore, this thesis also focuses on how knowledge can be deepened with the help of quantitative sustainability assessments and the challenges of conducting this type of assessment. This thesis shows that the state of knowledge regarding MUT's sustainability performance is low and scattered, with a lack of a holistic approach. Direct economic performance has gained the most attention, followed by indirect and social impact, and the environmental impact has so far barely been assessed. The sustainability performance depends to a large extent on the conditions of the specific case, and these should be considered when assessing the technology. Quantitative assessments have the potential to help deepen the knowledge of the sustainability implications of using MUT. The characteristics of MUT have some similarities with other types of physical infrastructure. Similarities are that the systems are long-lived, have project conditions that affect sustainability performance, and impact a broad spectrum of actors. One difference to typical infrastructure systems is that the owner and management structure of MUT is, by design, more complex as several types of utility systems are in use. The characteristics of MUT give some practical considerations that need to be addressed: data availability, including practitioners; detailed data; transparency; and flexibility. This thesis highlights the complexity of assessing MUT´s sustainability performance and advocates that future studies should have a learning-oriented approach so that the knowledge level can collectively and gradually improve over time rather than focusing on decision-oriented studies.