This study examined the impact of adding bentonite clay (concentration of 1.5 to 10 g/L) to a pilot-scale aerobic ceramic membrane bioreactor (AeCMBR) for treating pharmaceutical wastewater (PhWW). The hydraulic retention time (HRT) was maintained at 24 h; the dissolved oxygen was between 2 mg/L (on) and 4 mg/L (off) throughout operation. Organic and nitrogen pollution removal rates and heavy metal (Cu, Ni, Pb, Zn) reduction rates were assessed. The chemical oxygen demand (COD) removal efficiency exceeded 82%. Adsorption improved ammonia (NH4+) removal to 78%; the addition of 5 g of bentonite resulted in a 38% improvement compared with the process without bentonite. The average nitrate concentration decreased from 169.69 mg/L to 43.72 mg/L. The average removal efficiencies for Cu, Ni, Pb and Zn were 86%, 68.52%, 46.90% and 56.76%, respectively. Bentonite at 5 g/L significantly reduced membrane fouling. The cost–benefit analysis enabled us to predict that the process will meet the multiple objectives of durability, treatment performance and economic viability. The combination of an AeCMBR and bentonite adsorption has proven to be a valuable solution for treating highly polluted wastewater.

This study aims to optimize the removal of carbon and nitrogen pollutants from saline municipal wastewater using both membrane-based and biological treatment methods. It examines a pilot-scale sequential aerobic ceramic membrane bioreactor (AeCMBR) under various salinity levels (0–20 g NaCl/L) to assess biological processes and fouling behavior. While high COD removal rates of (≈90%) were consistently achieved, ammoniacal nitrogen removal dropped from 82 to 55% at 15 g NaCl/L, despite increased oxygenation flow rates. Notably, the biomass quickly adapted to salinity changes. Indicators such as mixed liquor suspended solids (MLSS), mixed liquor suspended volatiles (MLVSS), MLVSS/MLSS ratio, and sludge volume index (SVI) showed no significant correlation with increasing salt concentrations. Soluble microbial product (SMP) production was also unaffected by rising salinity levels. The transmembrane pressure (TMP) fluctuated, with the most pronounced trend at 15 g NaCl/L, even after reducing the flux from 20 to 15 L/m2/h. The primary fouling mechanism observed was reversible cake deposition. Overall, this research enhances our understanding of short-term operational impacts on AeCMBR performance as a function of different salinity levels.