Anaerobic co-digestion (AcoD) has the potential to utilise spare digestion capacity at existing wastewater treatment plants to simultaneously enhance biogas production by digesting organic rich industrial waste and achieve sustainable organic waste management. While the benefits of AcoD regarding biogas production and waste management are well established, the introduction of a new organic waste (i.e. co-substrate) with different chemical composition compared to residential sewage sludge is expected to impact on not only the anaerobic digestion process itself but also downstream processing of biogas and digestate. This work critically evaluates the potential impact (both positive and negative) of co-digestion on key downstream processes in the context of AcoD of sewage sludge and organic waste. AcoD can potentially lead to significant changes in biogas quality, digestate dewaterability, biosolids odour and the nutrient balance within the overall wastewater treatment process. The literature reviewed here suggests that effective management of these impacts can enhance the economic and environmental benefits of AcoD. Potential techniques to manage the impact of AcoD on downstream processing include co-substrate selection to minimise sulphur content, co-substrate pretreatment to improve dewaterability, process optimisation to minimize downstream impacts, biological desulphurisation of biogas, and side stream nutrient recovery. These techniques have been investigated and in some cases successfully applied for conventional anaerobic digestion. Nevertheless, further research is needed to adapt them for AcoD. In particular, the issue of nutrient accumulation due to AcoD can be seen as an opportunity to utilise recently commercialised technologies (e.g. Phosnix and Ostara) and currently emerging processes (e.g. forward osmosis and electrodialysis) for phosphorus recovery from food waste and wastewater.