To address the issue of insufficient carbon sources in urban sewage, which leads to poor nitrogen removal performance in sewage treatment systems, an anaerobic/anoxic/aerobic (AAO) pilotscale reactor was established. The reactor aimed to treat low C/N (chemical oxygen demand; COD/ total nitrogen; TN) municipal wastewater (C/N<5). To enhance nitrogen removal and investigate the mechanism in the AAO process, a Pall ring modified biological suspended filler was introduced to the aerobic zone after achieving partial nitrification and denitrification (PND). The results revealed that the activated sludge-biofilm composite system can be successfully formed within 40 days, with a stable loaded biomass on the membrane at 40.06 mg/g (measured by volatile suspended solids (VSS)/filler). The aerobic zone of the activated sludge-biofilm composite system demonstrated an increase in nitrite accumulation rate (NAR) and simultaneous nitrification and denitrification efficiency (SND), from 60.46% and 19.42% in the initial stage (stage 1) to 69.62% and 46.47% in the stable forming stage (stage 3), respectively. By promoting both PND and SND pathways for nitrogen removal, the effluent from the system exhibited decreased concentrations of ammonia nitrogen (NH 4 + -N) at 0.11 mg/L and total nitrogen (TN) at 4.55 mg/L, indicating the significant synergistic effect of the biofilm on nitrogen removal. 16S rRNA amplification and sequencing analysis revealed that Proteobacteria was the dominant microorganism in the 60-day biofilm, accounting for 76.12% of the relative abundance. The main ammonia oxidizing bacteria (AOB) were Nitrosomanas (1.77%) and Nitrosococcus (1.69%). Meanwhile, denitrification microbial species were found to have a substantial proportion (29.11%), along with a small amount of Anammox bacteria (Anammoxoglobus,