The urgent need for sustainable energy solutions has led to a growing interest in the innovative integration of hydropower and thermal energy systems for combined heat and power (CHP) production. This comprehensive review examines the current state of integration techniques, assessing their technical, economic, and environmental implications. Hydropower, as a renewable resource, provides a reliable and flexible energy supply, while thermal energy systems enhance overall efficiency and energy security. By synergizing these two energy sources, the integration maximizes resource utilization and addresses the intermittent nature of renewable energy. This review highlights the role of such integrated systems in contributing to global sustainability goals, including the United Nations Sustainable Development Goals (SDGs), particularly Goal 7 (Affordable and Clean Energy) and Goal 13 (Climate Action). The findings indicate that hydropower-thermal integration can achieve greenhouse gas emissions reductions of up to 30%, significantly improving energy efficiency by 20-30% compared to conventional systems. Furthermore, integrating these systems can lead to cost savings of approximately 15-25% in operational expenses, primarily through enhanced fuel utilization and reduced reliance on fossil fuels. Through an analysis of case studies and recent advancements in technology, this review offers valuable insights for policymakers, researchers, and industry stakeholders aiming to implement sustainable energy solutions. By embracing innovative integration approaches, we can pave the way for a more resilient and sustainable energy future.