This study investigates the long-term performance of a submerged membrane adsorption hybrid system (SMAHS) for organic matter removal from synthetic wastewater representing biologically treated wastewater by using a low dose of powdered activated carbon (PAC). A simple periodic backwash system is used to de-clog the hollow fiber membrane. In this reactor, bioreaction takes place due to the growth of the biomass in the system. This hybrid system was able to remove effectively the small- and large-molecular weight organic matters from 270 to 36,270 Da. The effect of PAC replacement in the reactor was also studied and it was shown that PAC replacement could enhance both biological activity and adsorption. With PAC replacement of 2.5% ((total amount)) per day, the total organic carbon (TOC) removal efficiency was 10% higher than without PAC replacement. In another long-term experiment, the TOC removal efficiency was maintained over 85% even after 55-day operation (with PAC replacement rate of 2.5% ((total amount)) every two days).