The use of fungal species to remove organic and inorganic pollutants from wastewater has shown to be a good alternative to traditional wastewater treatment technologies. Fungal pellets are well settling aggregates formed by self-immobilization. Their use in bioreactors is promising as it avoids the practical and technical difficulties usually encountered with dispersed mycelium. This review presents the mechanisms involved in the formation and growth of fungal pellets as well as the different factors that influence the stability of the pellets. The various types of fungal pelleted bioreactors that are used for wastewater treatment, their configuration, design and performance are reviewed. A summary of the different organic and inorganic pollutants that have been treated using fungal pelleted reactors, from dyes to emergent pollutants such as pharmaceuticals, is discussed from an application view-point. The operational issues such as bacterial contamination and longevity of this bioprocess under non-sterile conditions, as well as the reuse of fungal pellets are also encompassed in this review. (C) 2015 Elsevier B.V. All rights reserved.