Abstract: With the rapid development of China's economy and the continuous advancement of the urbanization process, urban domestic sewage also increases. To realize the sustainable utilization and recycling development of water resources, it is essential to explore energy-saving and efficient sewage treatment methods for the development of the national economy and the protection of water resources. In recent years, the anaerobic ammonia oxidation (Anammox) process has been widely studied in the treatment of the high concentrations of ammonia-nitrogen wastewater, such as landfill leachate, sludge digestion liquor and industrial sewage, as an efficient and energy-saving wastewater treatment method. Therefore, combined with the feasibility study and engineering application of the Anammox process in the treatment of the municipal domestic sewage at home and abroad, influential factors and prospects were analyzed and discussed, including the distribution and interaction of anammox microbial communities, the influence of granular sludge, and the performance of the combined process.