High pressure homogenization (HPH) pretreatment can improve sludge anaerobic digestion; however, the relationship among the material, energy conversion, and gas production efficiency was unclear under different operating conditions in sludge anaerobic digestion by HPH pretreatment. In this study, the performance of HPH pretreatment before sludge anaerobic digestion was investigated, and the relationship among the material, energy conversion, and gas production efficiency was explored. HPH pretreatment induced organic solubilization, and a maximum soluble chemical oxygen demand (SCOD)/total chemical oxygen demand (TCOD) of about 30% was achieved. Results showed that HPH pretreatment significantly improved the biogas production of sludge anaerobic digestion; the maximum increase in CH4 yield was 57%; and the anaerobic digestion period was shortened by about 10 days. The ratio of CH4 yield increment to volatile dissolved solids (VDS) increment was 0.21 mL/mg. The CH4 yield increment of 1 L/g volatile solid (VS) required a specific energy of 0.10 MJ/kg total solid (TS) by increasing the pressure with one cycle and 0.72 MJ/kg TS by increasing the cycle at 60 MPa. The minimum additive energy consumption of HPH pretreatment was 125 J/mL CH4 yield increment at 20 MPa with one cycle. Considering CH4 yield improvement and energy conservation, HPH pretreatment should maintain a pressure of no more than 60 MPa in one cycle. This study provides a theoretical reference for the practical application of HPH pretreatment in anaerobic digestion. HPH holds promise as a potential strategy for sewage sludge pretreatment to produce CH4 in anaerobic digestion.