Abstract: Anammox (anaerobic ammonium oxidation) is an important process of nitrogen cycle, with great potential for the practical use in removing nitrogen from the wastewater containing high concentration ammonium. However, the presence of high concentration organic carbon source is considered unfavorable to anammox. Coupling anammox and denitrification under the presence of organic carbon source could be a useful technique for removing both nitrogen and carbon. This paper reviewed the mechanisms of anammox-denitrification coupling process, functional microbial groups, initiation of the coupling process and its control, and related environmental affecting factors. The future research prospects and potential applications of anammox-denitrification coupling process in wastewater treatment were discussed.