Although the Millennium Development Goals (MDGs) do not include a clear energy-related goal, it would not be possible to achieve those goals without providing reliable and affordable energy services. The provision of energy services and enhancement of regional cooperation in that area are essential to achieving sustainable development and regional integration as they contribute to driving the production forward and creating employment opportunities in all economic sectors, which in turn lead to economic growth and social stability. This study addresses the relation between energy supply and sustainable development in the context of attaining the MDGs in the ESCWA region. It presents a review of the status of regional cooperation in the various energy-related areas, in particular electrical interconnection projects and gas pipeline networks in the region and the neighboring areas. It highlights existing and future benefits and obstacles and explores the future prospects and opportunities for regional cooperation in the areas of electrical interconnection, gas and petroleum pipeline networks, nuclear energy for peaceful use, renewable energy applications, manufacturing energy equipments and clean fuel technologies. The recommendations reached by the study stress the need to reinvigorate the regional cooperation mechanisms, establish a market for electrical power, conduct comprehensive studies, design integrated strategies, adopt policies and measures to encourage private sector participation in investing for development, and benefit from international experiences.