Small-scale biomass plants (< 20 MWe) represent a future possibility for an expansion of distributed generation using indigenous resources in Scandinavia. Today’s plants are typically operated in cogeneration mode but are characterized by low power-to-heat ratios and higher generation costs as compared to large-scale plants. However, the efficient use of biomass in a sustainable scheme requires the development of more efficient energy conversion systems. This paper explores possibilities to reach higher power-to-heat ratios and higher total efficiency levels with small-scale biomass plants producing electricity, district heat and/or district cooling (trigeneration). The analysis is based on flowsheet simulations of two modern cogeneration plants. Biomass pyrolysis and biomass gasification are combined with these base processes and the effect of the pyrolysed and gasified biomass amount to the power-to-heat ratios, electrical efficiencies and total efficiencies are simulated. Also district cooling production in trigeneration mode is studied as one promising option to increase the energy utilization of these processes. Advanced configurations for trigeneration are also discussed.