A novel process, inclined-plates hydrolytic tank (IHT) and membrane bioreactor (MBR), was used to treat domestic sewage continuously. In this study, the effects of carriers' addition on operational performances of IHT-MBR were studied at the hydraulic retention time of 5.4 h and the recycling rate of 200%. Experimental results indicated the removal efficiencies of chemical oxygen demand, total nitrogen and total phosphorus reached 86.8%, 82.9% and 89.6%, respectively, corresponding trans-membrane pressure decreased to 1.50 kPa/d at a packing ratio of 20%. Simultaneously, the scanning electron microscope and soluble microbial products analysis demonstrated that high nutrient removal and low membrane fouling were attributed to the attached growth of microorganisms on carriers. The bioattachment and adsorption of carriers not only decreased the soluble proteins and polysaccharide in MBR, but also provided good living environments for denitrifying bacteria and phosphorus-accumulating bacteria.