In Europe, there are major obstacles limiting the growth of rail freight. In this paper, we investigate problems related to the development of small multimodal terminals which are usually utilized to ensure a more environmentally friendly freight transport and serve metropolitan areas with daily train shuttles arriving from ports. The small size of such terminals and limitations of the storing area, and service and cost constraints, require that resource use is optimal, handling operations for overnight train shuttle schedules are timely, and final truck delivery is optimized. Besides designing the complete service, an optimization-simulation approach is proposed for container transportation, handling operations and container stacking in the small rail/road terminal, as well as for final delivery, to optimize resource use and time. In an original multidisciplinary perspective, the case of a Le Havre-Paris intermodal shuttle is presented using real data. Optimization/simulation results are fed into the economic model to ensure cost efficiency and conditions for efficiency, profitability for investors and also to measure the environmental impact. Our experimental results show the efficiency of our optimization-simulation approach, and the methodology used delivers full guidelines for the implementation of similar terminals. Several important research directions are finally pointed out.