Composting from organic municipal solid waste (MSW), such as a separate waste collection, is a valid tool for eliminating a considerable amount of waste that would otherwise be destined for landfills and incinerators, thus representing an effective complement to traditional forms of recycling. It allows organic substance to be recovered and reintegrated into the soil, thus preventing erosion phenomena, increasing the biological fertility of the soil and contributing significantly to the restoration of impoverished sites. Modern winegrowing must address the issue of vineyard fertility in the sustainability context. The goal of this study was to assess the advantages of distributing a sustainable product to the vineyard that can achieve vine balance (vegetative and productive equilibrium). In a Vitis vinifera L. Sangiovese cv., vineyard, four soil treatments were applied (three compost rates and a control): municipal solid waste compost (40 tons per hectare – MSW40, 15 tons per hectare – MSW15, 2.5 tons per hectare – MSW2.5), and no compost (CTRL). The vine physiology (leaf gas exchange and water potential) and berry compositions (phenolic and technological maturity) were studied during the 2018–2019 growing seasons in the Sieci area, Italy. The results of this experiment provide some general insights showing that MSW compost options can be expected to reduce water stress, balanced vine performance and provide sustainable recirculation of organic matter. MSW compost is a true agronomic and environmental resource.