In the face of material shortages, growing environmental awareness, and technical advancement, incinerated waste materials are being considered secondary resources. Especially incinerated sewage sludge ash is of interest due to its massive and increasing production and relatively stable composition with a satisfying concentration of elements of value. This paper revises the basic methods for recovery of valuable components from incineration sewage sludge and simultaneous removal or stabilization of elements that may negatively influence the environment with further ash usage or storage. The presented work focuses on collating and analysing the efficiency of currently used approaches as well as their limitations and perspectives for future development. Chemical methods analysed include acidic and alkaline leaching, chelating, and sequential leaching. Due to scarce examples from literature, the exploration of a microbiological approach focuses on the mechanisms and potential for application of different microorganisms for element extraction. The methods described are relatively efficient and affordable, yet still need further development. Specifically, microbiological approaches are rarely used for incineration sewage sludge treatment regardless of their potential advantages over other approaches. Constant mineral and chemical composition within one incineration plant can vary among plants due to many factors, so a well-established range of techniques and an individual approach are important.