This article examines the process of pressure agglomeration of garden waste compost mixed with sewage sludge ash (SSA) to produce granulated fertilizer material, using a flat die rotating compaction roller system. The study evaluated the effects of adding SSA at mass fractions of 0%, 10%, 20%, 30%, 40%, and 50% on the process of pelleting and the quality of pellets. Increasing the SSA content from 0% to 50% reduced the power demand of the pellet mill by 13.5% (from 4.92 kW to 4.25 kW), decreased the kinetic strength of the pellets by 0.7% (from 98.21% to 97.56%), and slightly increased the pellet density, by 2.6% (from 1641.17 kg·m−3 to 1684.09 kg·m−3). The high density of the pellets, i.e., over 1600 kg·m−3, indicates that they are of market quality. A chemical analysis revealed that SSA addition positively influenced fertilizer properties. A higher SSA content (up to 50%) decreased the nitrogen content (1.4% to 0.73%) but significantly increased the phosphorus content (0.32% to 2.67%). The potassium content remained stable, at approximately 1.3%. The process of co-pelleting also diluted the heavy metals present in SSA, reducing the final product’s lead and cadmium levels to meet the standards set for fertilizers. Although the SSA contained high levels of heavy metals (lead: 93.89 mg·kgd.m.−1, cadmium: 11.28 mg·kgd.m.−1), these elements were not detected in the compost. Co-pelleting of compost and SSA produces high-density, high-quality fertilizer pellets with favorable nutrient profiles and heavy metal contents, complying with regulatory standards. Moreover, by converting garden waste and SSA into valuable agricultural products, the process supports sustainable waste management. This study evaluated the impact of SSA additives on the composition and water absorption of the granulate, providing insights into its suitability as an eco-friendly fertilizer alternative and its potential implications for sustainable agricultural practices.