This chapter summarizes the theoretical and conceptual foundations of sustainability balanced scorecard (SBSC), which have been published and developed further over the past fifteen years. It provides a theoretical and conceptual overview of the SBSC approach according to F. Figge and S. Schaltegger and T. Dyllick. The chapter presents a summary of an early, yet comprehensive and insightful case study on Hamburg Airport, which has been extended and adapted. It discusses some general relationships between SBSCs and performance measurement and reporting. The case of Hamburg Airport is prototypical regarding the practical implementation of an integrated measurement and reporting system. The chapter introduces a framework based on a combination of the SBSC and sustainability accounting and reporting. The case of Hamburg Airport includes several different interactions between business, the natural environment, and society. Dealing with these interactions is the purpose of sustainability performance measurement and management.