This study presents the biological treatment of poultry slaughterhouse wastewater (PSW) using a combination of a biological pretreatment stage, an expanded granular sludge bed reactor (EGSB), and a membrane bioreactor (MBR) to treat PSW. This PSW treatment was geared toward reducing the concentration of contaminants present in the PSW to meet the City of Cape Town (CoCT) discharge standards and evaluate an alternative means of treating medium- to high-strength wastewater at low cost. The EGSB used in this study was operated under mesophilic conditions and at an organic loading rate (OLR) of 69 to 456 mg COD/L·h. The pretreatment stage of this laboratory-scale (lab-scale) plant played an important role in the pretreatment of the PSW, with removal percentages varying between 20% and 50% for total suspended solids (TSS), 20% and 70% for chemical oxygen demand (COD), and 50% and 83% for fats, oil, and grease (FOG). The EGSB further reduced the concentration of these contaminants to between 25% and 90% for TSS, 20% and 80% for COD, and 20% and >95% for FOG. The last stage of this process, i.e., the membrane bioreactor (MBR), contributed to a further decrease in the concentration of these contaminants with a peak removal performance of >95% for TSS and COD and 80% for the FOG. Overall, the system (pretreatment–EGSB–MBR) exceeded 97% for TSS and COD removal and 97.5% for FOG removal. These results culminated in a product (treated wastewater) meeting the discharge standards.