This study investigated the performance of an integrated osmotic and microfiltration membrane bioreactor for real sewage employing baffles in the reactor. To study the biofouling development on forward osmosis membranes optical coherence tomography (OCT) technique was employed. On-line monitoring of biofilm growth on a flat sheet cellulose triacetate forward osmosis (CTA-FO) membrane was conducted for 21 days. Further, the process performance was evaluated in terms of water flux, organic and nutrient removal, microbial activity in terms of soluble microbial products (SMP) and extracellular polymeric substance (EPS), and floc size. The measured biofouling layer thickness was in the order sodium chloride (NaCl) > ammonium sulfate (SOA) > potassium dihydrogen phosphate (KH2PO4). Very high organic removal (96.9 +/- 0.8%) and reasonably good nutrient removal efficiency (85.2 +/- 1.6% TN) was achieved. The sludge characteristics and biofouling layer thickness suggest that less EPS and higher floc size were the governing factors for less fouling.