Physicochemical studies on wastewater quality and microscopic analyses of activated sludge are necessary to properly evaluate the condition of activated sludge. The aim of this study was to evaluate the application of the sludge biotic index to determine when a change in treatment quality is short-lived, caused by, e.g., a change in influent quality or quantity, and when it indicates adverse changes in the biocenosis of activated sludge, which would very likely result in the lower efficiency of wastewater treatment in the near future. The objects of the study were two identical parallel running small wastewater treatment plants. The following indicators of contamination were analyzed: the chemical oxygen demand (COD), biochemical oxygen demand (BOD 5 ), and total suspended solids (TSS). The authors additionally carried out a microscopic analysis. The study confirmed a correlation between the sludge biotic index and the removal efficiency of COD and BOD 5 ; however, no correlation was found between the sludge biotic index and the removal efficiency of total suspended solids. The presence of metazoan microorganisms coincided in time with a good effluent treatment efficiency. When their quantity declined, a decrease in the efficiency of wastewater treatment was also observed.