A pilot scale study was conducted using an Air-Fluidized-Bed Biofilm Reactor (AFBBR) system with a Multi Media Filter (MMF). Soluble BOD (S-BOD) concentration in the effluent of the AFBBR had a correlation with total BOD (T-BOD) and Suspended Solids (SS) concentration in the effluent of the MMF. The lower the S-BOD in the effluent of the AFBBR was, the lower was not only T-BOD but also SS in the effluent of the MMF. It was found that as treatment proceeded, S-BOD was removed and the particle size of SS increased in the AFBBR. These results suggested that the mechanism of BOD removal in this system was: S-BOD was removed and a part of the S-BOD was changed to SS and the particle size of the SS increased in the AFBBR, and then the SS was removed by the MMF. Thus not only the T-BOD but also the SS in the effluent of MMF was lower when the S-BOD in the effluent of the AFBBR was lower. When the S-BOD in the effluent of the AFBBR was 8mg/L, T-BOD and the SS in the effluent of the MMF were 10mg/L and 4mg/L, respectively. In order to have an average S-BOD value in the effluent of the AFBBR of about 8mg/L, the T-BOD loading and the S-BOD loading needed to be less than 1.3kg/m3/day and 0.45 kg/m3/day, respectively. Even when the BOD loading was high, nitrification still occurred in this system.