Different technologies for tertiary wastewater treatment are compared in their environmental impacts with life cycle assessment (LCA). Targeting very low phosphorus concentration (50–120 µg/L) and seasonal disinfection of wastewater treatment plant (WWTP) secondary effluent, this LCA compares high-rate sedimentation, microsieve, dual media filtration (all with UV disinfection), and polymer ultrafiltration or ceramic microfiltration membranes for upgrading the large WWTP Berlin-Ruhleben. Results of the LCA show that mean effluent quality of membranes is highest, but at the cost of high electricity and chemical demand and associated emissions of greenhouse gases or other air pollutants. In contrast, gravity-driven treatment processes require less electricity and chemicals, but can reach significant removal of phosphorus. In fact, dual media filter or microsieve cause substantially lower specific CO2 emissions per kg P removed from the secondary effluent (180 kg CO2-eq/kg P, including UV) than the membrane schemes (275 kg CO2-eq/kg P).