Since the 1950s sugarcane production has grown rapidly from less than 0.5 billion tonnes in the late 50s to reach over 1.9 billion tonnes in 2012 on about 27 million hectares of agricultural land. This expansion has been boosted by the high demand for bioethanol promoted as a sustainable bioenergy source which accounted in 2010 for the biggest share of the global biofuel market. Despite its benefits, the scientific debate on sugar is growing especially that counterarguments are so many, including negative impacts on different interacting ecosystems and human well-being, e.g. bigger stress on land and water resources, environmental externalities on air, a harmful impact on the biodiversity and endemic species, negative environmental externalities, health, and socio-economic aspects. This paper provides a narrative systematic review (SR) of the impacts of sugarcane production on these different ecosystems employing the ecosystem services framework for its acceptance by policy-makers. The references included for the SR were 163 and results showed that the majority of the studies are from Brazil, Australia, South Africa and the USA (≈ 75% of the literature), most of them were from peer-reviewed journals (85%), and most of the case studies adopted a quantitative research approach (93%). The literature assessed showed that sugarcane, like all agro-systems, depends on the practices and techniques to transform negative impacts into positive externalities on ecosystems and human well-being. However, the literature studied failed to include the inter-linkage in sugarcane production impacts’ and therefore to evaluate the related ecosystem services with respect to the Millennium Ecosystem Assessment (MA) framework to account for existing trade-offs. Therefore, the findings are addressed to the scientific community and decision-maker for an intensification of interdisciplinary and integrated research based on the MA framework to cover all ecosystem services, for sustainable development of the sugarcane sector.