A pilot study was conducted to study the treatability of high-strength landfill leachate by a combined process including upflow anaerobic sludge blanket (UASB), carbon removal (C-stage) moving bed biofilm reactor (MBBR) and ANITA™ Mox process. The major innovation on this pilot study is the patent-pending process invented by Veolia that integrates the above three unit processes with an effluent recycle stream, which not only maintains the low hydraulic retention time to enhance the treatment performance but also reduces inhibiting effect from chemicals present in the high-strength leachate. This pilot study has demonstrated that the combined process was capable of treating high-strength leachate with efficient chemical oxygen demand (COD) and nitrogen removals. The COD removal efficiency by the UASB was 93% (from 45,000 to 3,000 mg/L) at a loading rate of 10 kg/(m3·d). The C-stage MBBR removed an additional 500 to 1,000 mg/L of COD at a surface removal rate (SRR) of 5 g/(m2·d) and precipitated 400 mg/L of calcium. The total inorganic nitrogen removal efficiency by the ANITA Mox reactor was about 70% at SRR of 1.0 g/(m2·d).