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This research studied integrated fixed film activated sludge (IFAS) technology to simultaneously remove N and P in real municipal wastewater by combining anammox biofilms with flocculent activated sludge for enhanced biological P removal (EBPR). The study was conducted in a sequencing batch reactor (SBR) operated as a conventional A2O (anaerobic-anoxic-oxic) process with an 8.8 h hydraulic retention time. After achieving steady-state operation, the reactor showed robust performance, with average removal efficiencies of 91.3±4.1% for total inorganic nitrogen (TIN) and 98.4±2.4% for phosphorus (P). Denitrifying polyphosphate accumulating organisms (DPAOs) were responsible for 15.9% of P uptake during the anoxic phase, while biofilms showed anammox activity in the aerobic step. The IFAS configuration with a low solid retention time (SRT) of 5 days prevented the washout of biofilm anammox bacteria and allowed selective washout of unwanted organisms. The results demonstrated the successful coexistence of anammox bacteria with other bacteria for efficient nutrient removal in real wastewater conditions.