The synthesis of active pharmaceutical ingredients (APIs) is commonly perceived as more efficient when performed using continuous-flow methods, whereas batch processes are often seen as less favorable due to their limitations in yield, heat and mass transfer, and safety. This perception largely stems from existing studies that focus on green metrics such as the E-factor and yield. However, a comprehensive comparison of batch and flow processes through full techno-economic analyses (TEA) and life-cycle assessments (LCA) remains underexplored, leaving key aspects of their environmental and economic impacts inadequately assessed. This work addresses this gap by presenting a detailed comparison of batch and flow syntheses of seven industrially relevant APIs, including amitriptyline hydrochloride, tamoxifen, zolpidem, rufinamide, artesunate, ibuprofen, and phenibut. Eleven environmental impact categories within the framework of nine planetary boundaries were assessed, and the study also included an evaluation of capital and operating costs for both production methods. The results demonstrated that, on average, continuous-flow processes are significantly more sustainable with improvements in energy efficiency, water consumption, and waste reduction. Flow processes also show a marked reduction in carbon emissions and up to a 97% reduction in energy consumption, highlighting their potential for greener API manufacturing. Despite these advantages, the study identified areas where the continuous-flow technology requires further development. Specifically, manufacturing certain APIs in flow show lower-than-average improvements in operating expenditure and land system changes, the latter being directly correlated with the consumption of organic solvents, that can be comparable to or even higher than in batch. These challenges highlight the need for further optimization of flow processes to fully realize their potential in API production.