In this chapter we discuss the importance of vehicle routing problems in improving sustainability of temperature-controlled transportation of perishable products. Transportation of these products requires substantial amounts of energy to optimize the product environment and delay the decay process. Because of this, minimizing traveling distance is not a sufficient objective to improve sustainability of this type of transportation systems. To achieve a more sustainable distribution of perishable products, other objectives related to spoilage and greenhouse gas emissions should also be evaluated. Moreover, it is important that the potential of new technologies and alternative logistical concepts (e.g., collaboration) are explored and analyzed quantitatively.