A thermophilic aerobic membrane reactor (TAMR) treating high-strength COD liquid wastes was submitted to an integrated investigation, with the aim of characterizing the biomass and its rheological behaviour. These processes are still scarcely adopted, also because the knowledge of their biology as well as of the physical-chemical properties of the sludge needs to be improved. In this paper, samples of mixed liquor were taken from a TAMR and submitted to fluorescent in situ hybridization for the identification and quantification of main bacterial groups. Measurements were also targeted at flocs features, filamentous bacteria, and microfauna, in order to characterize the sludge. The studied rheological properties were selected as they influence significantly the performances of membrane bioreactors (MBR) and, in particular, of the TAMR systems that operate under thermophilic conditions (i.e., around 50 ∘ C) with high MLSS concentrations (up to 200 gTS L −1 ). The proper description of the rheological behaviour of sludge represents a useful and fundamental aspect that allows characterizing the hydrodynamics of sludge suspension devoted to the optimization of the related processes. Therefore, in this study, the effects on the sludge rheology produced by the biomass concentration, pH, temperature, and aeration were analysed.