This study consists of a review on the removal efficiencies of a wide spectrum of micropollutants (MPs) in biological treatment (mainly membrane bioreactor) coupled with activated carbon (AC) (AC added in the bioreactor or followed by an AC unit, acting as a post treatment). It focuses on how the presence of AC may promote the removal of MPs and the effects of dissolved organic matter (DOM) in wastewater. Removal data collected of MPs are analysed versus AC dose if powdered AC is added in the bioreactor, and as a function of the empty bed contact time in the case of a granular activated carbon (GAC) column acting as a post treatment. Moreover, the enhancement in macropollutant (organic matter, nitrogen and phosphorus compounds) removal is analysed as well as the AC mitigation effect towards membrane fouling and, finally, how sludge properties may change in the presence of AC. To sum up, it was found that AC improves the removal of most MPs, favouring their sorption on the AC surface, promoted by the presence of different functional groups and then enhancing their degradation processes. DOM is a strong competitor in sorption on the AC surface, but it may promote the transformation of GAC in a biologically activated carbon thus enhancing all the degradation processes. Finally, AC in the bioreactor increases sludge floc strength and improves its settling characteristics and sorption potential.