The French version of vertical-flow constructed wetlands (VFCWs) is characterized by treating directly raw wastewater on a first-stage filter. VFCW is a well developed technology with more than 3,500 plants in operation in France. However, VFCW performance may be affected under the low temperatures reached in mountain areas during winter. The effect of cold conditions over 12 plants, ranging from 75 to 1,900 person equivalent and from 680 to 1,500 m above sea level, was studied over 2 years. The plant hydraulic loads, and air and filter temperatures were continuously measured. In addition, 24-h flow proportional sampling, at each stage of treatment, was conducted in summer (as a reference) and winter. Online measurements of ammonium and nitrates were also analyzed to describe the nitrogen removal dynamics. Since no impact on chemical oxygen demand (COD), biochemical oxygen demand (BOD) and suspended solids removal was observed, the effect of cold temperatures on nitrification was further analyzed. Nitrogen removal was relatively unaffected during winter season. Significant effects were confirmed only for the second stage for loads above 10 gTKN/m2/d (TKN: total Kjeldahl nitrogen). Temperature profiles allowed analysis of the filter buffer capacity in terms of freezing. Under minimal air temperature of −19 °C, no critical operation was observed, although design and operation recommendations can be provided to ensure suitable plant performances.