In general, hospitals in Indonesia treat wastewater using a biological method, namely an aerobic anaerobic biofilter system. The anaerobic aerobic biofilter Waste Water Treatment Plant (WWTP) system in the hospital consists of a screen tub, fat catcher tank, initial settling tank, aerobic biofilter pond, aerobic biofilter and final settling tank, chlorination tank and indicator pond. So that this wastewater treatment method has the disadvantage of requiring an expensive investment, because it requires a large area of land, uses biofilters, pumps, blowers and chemicals in its operation. Alternative methods for treating hospital wastewater can use a microfiltration membrane, where the results of the study show that the removal of oily wastewater reaches 82.5%, BOD 90%, COD 85% and total Coli up to 70%. In addition, it can remove particles from wastewater measuring 0.04 to 100 microns. The problem faced in the use of microfiltration membranes is the rapid occurrence of fouling/saturation on the surface of the microfiltration membrane causing the operation time of wastewater treatment not to be in a long time. The duration of this treatment causes the problem of a small amount of wastewater being treated and other problems, membrane replacement is faster. The purpose of the research is to determine the performance of the preliminary treatment for microfiltration membranes made from alum, silica sand and activated carbon for parameters ph, bod, cod, tss, ammonia, oil and fat, total coliform wastewater. Analyzing the effect of differences in pre-processing materials for microfiltration membranes made from alum, silica sand and activated carbon on the quality parameters of ph, bod, cod, tss, ammonia, oil and fat, total coliform. The research method carried out is a quasi-experimental, namely research that aims to explain things that will happen to the research variables through manipulation and control of variables with a design using pre test (before treatment) and post test (after treatment) to the object under study. The results of the study are as follows: 1) the average quality of hospital wastewater is temperature 28.8 °C, pH 7, BOD 79 mg/l, COD 167.05 mg/l, Total Suspended Solid 68 mg/l, Ammonia 4 mg/l, Phosphate 0.745 mg/l, Fatty Oil 1.64 mg/l, coliform 2,200 mpn/100 ml. 2) Analysis of the comparison of the most effective materials on the parameters, for BOD is silica sand 78.24%, COD is silica sand 56.25%, total suspended solid is 83.42% activated carbon, ammonia is silica sand 56.49%, phosphate is 80.43% activated carbon, fatty oil is 80.43% alum, coliform is a 40.91% microfiltration membrane.