The biomass fraction of processed municipal and industrial wastes added to soil can maintain, and in some case improve, the soil’s organic fertility. One of the main constraints in the agricultural use of the sewage sludge is its content of heavy metals. In the long term, soil administration of sewage sludge in agriculture could result in a risk of environmental impact. The aim of this research was to evaluate the effects of medium-term fertilization with sewage sludge diversely processed on the soil’s organic carbon content and humification – mineralization soil’s processes and on the physical and mechanical properties of soil. Furthermore, the heavy metals accumulation in soil, in their total and available form, has been investigated. After eight years of administration to soil, the use of sewage sludge as an agricultural soil amendment has contributed to maintaining the soil’s organic fertility. An increase in concentrations of total Ni and Zn was detected in soil. For bioavailable form (DTPA-extractable) this trend was evidenced for all heavy metals analysed. However, the concentrations of total and available heavy metals in the soil did not exceed the legal threshold established by Italian law for unpolluted soils.