This study presents a literature review on the treatment of domestic sewage in controlled environments having the anaerobic process and specifically the upflow anaerobic sludge blanket (UASB) concept as the core, under natural hot conditions. The UASB process application is however beset by the preponderance of suspended solids, and the paper looks at its optimization via pre- and post-treatments to curb the prevailing problems, in the light of possible discharge and re-use/recycling/resource recovery.. leading to efficient environmental protection. Pre-treatment clarification could be done with ferric chloride/polyetectrolyte, so that phosphate precipitates during the process. The pre-treated liquid phase can be submitted to a high rate anaerobic process, using the simple and robust UASB technology. In a subsequent post-treatment step, ammonium can be removed by ion exchange using a zeolite column through which the wastewater percolates after leaving the anaerobic digester. The various stages can also eliminate a large fraction of the pathogens present in the raw wastewater, mainly through the pre-treatment sedimentation and the ion exchange filtration. The sludge produced in the precipitation stage can be stabilized in a conventional anaerobic digester. Integration of the different treatment steps provides a sustainable technology to treat domestic sewage under hot climate conditions. (c) 2005 Elsevier Ltd. All rights reserved.