In the last decade, several novel and cost-effective biological nitrogen removal technologies have been developed. The discovery of anaerobic ammonium oxidation (Anammox), about 15 years ago, has resulted in new opportunities for research and development of sustainable nitrogen removal systems. Compared to conventional nitrification/denitrification, Anammox eliminates necessity of external organic carbon source, has a smaller production of excess sludge, reduces energy demand for aeration (up to 60-90%) and CO2 emissions (up to 90%). Systems based on Anammox can be of great help to comply with stricter wastewater discharge regulations and reduce environmental problems caused by nutrients discharges (e.g. eutrophication). This thesis investigates the partial nitritation/Anammox in one stage system under oxygen limited condi-tions (also called CANON or Deammonification) and with the Moving Bed Biofilm Reactor (MBBR™) technology. Anammox process coupled with partial nitritation can be particularly suitable to treat ammo-nium-rich wastewater with low content of biodegradable organic matter, such as the reject water from dewatering of digested sludge, which is usually recirculated back to the main stream of wastewater treat-ment plants, accounting for the 15-20% of the total nitrogen load. Partial nitritation/Anammox process was successfully tested on a pilot plant scale for four months at 25°C, in a 200 L Continuous Stirred Tank Reactor (CSTR), filled with 40% of Kaldnes media (model K1). At an Ammonium Surface Load (ASL) of 3.45 gN m-2d-1, the removal rate was about 2.85 gN m-2d-1. Removal efficiencies of 95%, 85% and 83% were respectively achieved for NH4+-N, inorganic nitrogen, and Total Nitrogen (TN). Bacteria activity was followed by batch tests such as Specific Anammox Activity (SAA), Oxygen Uptake Rate (OUR) and Nitrate Uptake Rate (NUR), which revealed an increase in activi-ty for Nitrosomonas and Anammox bacteria within the biofilm. Dissolved oxygen concentration in the bulk liquid was a crucial parameter, whereas pH and conductivity turned out to be two useful monitoring tools. Two laboratory-scale reactors were previously run for two months each, in order to evaluate the one-stage partial nitritation/Anammox process with a lower ASL. One reactor was fed with diluted reject water, whereas the other one treated the effluent from UASB (Up-flow Anaerobic Sludge Blanket) reactor after sand filtration. Fairly good efficiency (>75%) were reached but, however, in the last case the low ammo-nium nitrogen load could represent a problem for a stable full-scale installation and long-term growth of Anammox bacteria. Some suggestions for full-scale implementation and further research are proposed in the last chapter of this master thesis.