Combined cultures were developed from anaerobic granular and suspended aerobic cultures in three upflow sludge blanket reactors aerated at 10 mL air/min 4 h / day ͑R2͒, every other day ͑R3͒, and 24 h / day ͑R4͒. The use of combined cultures was found to be advantageous compared to the anaerobic granules for the treatment of low-strength wastewaters. During municipal wastewater treatment at influent 5-day biochemical oxygen demand ͑BOD 5 ͒ concentration of 53-118 mg/ L ͑hydraulic retention time: 0.75 day͒, combined cultures in R2, R3, and R4 exhibited average BOD 5 removal efficiencies of 52, 75, and 76%, respectively. The use of these cultures might be proposed as an alternative for municipal wastewater treatment due to their advantages such as achievement of required discharge standards, prevention of biomass loss/settleability problems unlike activated sludge systems and possible methanogenic activity, as well as high settling characteristics comparable to those of anaerobic granules.