This review article compiles the various advances made since 2008 in sustainable high-rate anaerobic technologies with emphasis on their performance enhancement when treating agro-food industrial wastewater. The review explores the generation and characteristics of different agro-food industrial wastewaters; the need for and the performance of high rate anaerobic reactors, such as an upflow anaerobic fixed bed reactor, an upflow anaerobic sludge blanket (UASB) reactor, hybrid systems etc.; operational challenges, mass transfer considerations, energy production estimation, toxicity, modeling, technology assessment and recommendations for successful operation.