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A strategy that integrates the anammox and hydroxyapatite crystallization in an up-flow anaerobic fixed-bed reactor (UAF was investigated to simultaneously remove nitrogen and recover phosphorus. During the 430 days of operation, 73.1 ± 6.6% of influent phosphorus was removed with an efficient nitrogen removal efficiency of 87.8 ± 1.7%. After long-term operation, numerous acicular and micron-sized crystals were observed on the matured biofilm, of which the phosphorus content was around 10.21% (wt%) and hydroxyapatite was the main form o