Rural slaughterhouses often lack strict effluent treatment rules, resulting in inadequate treatment prior to release into water bodies. Slaughterhouse wastewater (SWW) is a high-strength effluent, posing risks of contamination to ecosystems and human health. To tackle the need for suitable technologies in these areas, this study evaluated a 215 L pilot-scale fixed-bed biofilm reactor (FBBR), known for its simplicity in implementation, operation, and maintenance. During the operation, an initial startup period, with the liquid fraction of fruit and vegetable waste (LF-FVW) was conducted, followed by a gradual transition to SWW, creating a co-digestion period during the substrate transition. Organic load variations (1.59, 3.35, and 4.00 kgCOD/m3·d), corresponding to flow rates of 50, 75, and 120 L/d, respectively, were implemented to address potential alterations in effluent concentration and composition in authentic rural settings. Removal rates of up to 83.69, 91.81, 87.00, and 92.00% were achieved for COD, sCOD, TS, and VS, respectively, with an average removal of 32.00% for TN, and biogas production exceeded 300 L/h at 4.00 kgCOD/m3·d. These results suggest that FBBR implementation in rural areas effectively confronts SWW treatment challenges by reducing contamination, generating biogas, and adapting to rural conditions.