Primary and chemically enhanced primary wastewater treatment with microsieving (disc or drum filtration) was studied at the large pilot scale at seven municipal wastewater treatment plants in Europe. Without chemical dosing, the reduction of suspended solids (SS) was (on average) 50% (20–65%). By introducing chemically enhanced primary treatment and dosing with cationic polymer only, SS removal could be controlled and increased to >80%. A maximum SS removal of >90% was achieved with a chemical dosing of >0.007 mg polymer/mg influent SS and 20 mg Al3+/L or 30 mg Fe3+/L. When comparing sieve pore sizes of 30–40 μm with 100 μm, the effluent SS was comparable, indicating that the larger sieve pore size could be used due to the higher loading capacity for the solids. Phosphorus removal was adjusted with the coagulant dose, and a removal of 95–97% was achieved. Moreover, microsieving offers favourable conditions for automated dosing control due to the low retention time in the filter.