In China, the number of hospitals has increased to 19,712 in 2008, with the production of hospital wastewater reaching 1.29 x 10(6) m(3)/d. Membrane bioreactor (MBR) technology presents a more efficient system at removing pathological microorganism compared with existing wastewater treatment systems. In the past 8 yr, over 50 MBR plants have been successfully built for hospital wastewater treatments, with the capacity ranging from 20 to 2000 m(3)/d. MBR can effectively save disinfectant consumption (chlorine addition can decrease to 1.0 mg/L), shorten the reaction time (approximately 1.5 min, 2.5-5% of conventional wastewater treatment process), and attain a good effect of inactivation of microorganism. Higher disinfection efficacy is achieved in MBR effluents at lower dose of disinfectant with less disinfection by-products (DBPs). Moreover, when capacity of MBR plants increases from 20 to 1000 m(3)/d, their operating cost decreases sharply. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved.