A novel full scale modified A(2)O (anoxic/anaerobic/aerobic/pre-anoxic)-membrane bioreactor (MBR) plant combined with the step feed strategy was operated to improve the biological nutrient removal (BNR) from low C/N ratio municipal wastewater in Southern China. Transformation of organic carbon, nitrogen and phosphorus, and membrane fouling were investigated. Experimental results for over four months demonstrated good efficiencies for chemical oxygen demand (COD) and NH4+-N removal, with average values higher than 84.5% and 98.1%, respectively. A relatively higher total nitrogen (TN) removal efficiency (52.1%) was also obtained at low C/N ratio of 3.82, contributed by the configuration modification (anoxic zone before anaerobic zone) and the step feed with a distribution ratio of 1 : 1. Addition of sodium acetate into the anoxic zone as the external carbon source, with a theoretical amount of 31.3 mg COD per liter in influent, enhanced denitrification and the TN removal efficiency increased to 74.9%. Moreover, the total phosphate (TP) removal efficiency increased by 18.0%. It is suggested that the external carbon source is needed to improve the BNR performance in treating low C/N ratio municipal wastewater in the modified A(2)O-MBR process.