The Manila clam Tapes philippinarum is one of the most important commercial mollusc species in Europe. Intensive clam farming takes place in several coastal lagoons of the Northern Adriatic Sea, supporting local economy but raising the problem of the environmental sustainability of this activity. In this work, we propose a bioeconomic model that provides guidelines for an efficient management of intensive clam farming. Clam demography is described by a stochastic model of growth and survival, accounting for the effect of water temperature, seeding substratum and density dependence of vital rates. The model is calibrated on and applied to the case of Sacca di Goro, a lagoon located in the Po River Delta (Northern Italy). We consider two distinct management criteria: the optimisation of the marketable yield and the optimisation of monetary benefits, respectively. The use of a stochastic formulation allows us to reveal the existing trade-off between maximizing the median yield or profit and minimizing its variance. A Pareto analysis shows that seeding in spring or fall on sandy substrata and harvesting 18 months later provides the best compromise between these two contrasting objectives, maximizing profits while minimizing the associated uncertainty level. Finally, we show that seeding clams at high densities (more than 750 clams m-2 on muddy substrata and more than 1500 elsewhere) can have not only a potentially negative impact on the ecological sustainability of clam farming, but also a negative economic effect.