Abstract: A full-scale test was conducted with a process combining two-phase anaerobic, aerobic and ANAMMOX to treat mixed wastewater from chlortetracycline and starch production. 272 days of continuous experimental result demonstrated that the removal rate of COD_Cr, ammonia and total nitrogen (TN) of the combined process was 94%-98%, 96.9% and 89.8% when the influent COD_Cr, ammonia and TN were 4 000-18 000 mg/L, 100-800 mg/L(average value 530 mg/L) and 200-1 000 mg/L(average value 624.4 mg/L), respectively. The effluent average COD_Cr, ammonia and TN concentration were 514, 15.6 and 59.2 mg/L, respectively. The combined process could effectively reduce the organic load, the burden on the follow-depth treatment, and also the operating and investment costs of conventional materialized denitrification by using biological treatment. The ammonia and TN of effluent could meet the Discharge Standards of Water Pollutants for Pharmaceutical Industry Fermentation Products (GB 21903-2008).