Nitritation-anammox process was successfully established in pilot- and full-scale integrated fixed-film activated sludge (IFAS) reactors. An average nitrogen removal efficiency of 80% was achieved under ammonium loading rate of 0.7-1.3 kg N/(m(3) d) in the pilot-scale reactor (12 m(3)). Moreover, molecular analysis showed that ammonium oxidizing bacteria (AOB) were more abundant in the activated sludge while anammox bacteria were primarily located in the biofilm. The segregation of AOB and anammox bacteria enhanced the nitrogen removal rate and operational stability. Furthermore, a full-scale IFAS reactor of 500 m(3) was set-up to treat sludge dewatering liquors. An average nitrogen removal efficiency of 85% and a nitrogen removal rate of 0.48 kg N/(m(3) d) were achieved after inoculation. It was noted that high influent suspended solids would seriously affect the performance of the IFAS system. Therefore, a pre-treatment was proposed to reduce suspended solid in the full-scale application. (C) 2015 Elsevier Ltd. All rights reserved.