In this study, nitrite reduction and methanogenesis in a single-stage upflow anaerobic sludge blanket (UASB) reactor was investigated, using high-strength synthetic domestic wastewater as substrate. To assess long-term effects and evaluate the mechanisms that allow successful nitrite reduction and methanogenesis in a single-stage UASB, sludge was exposed to relatively high nitrite loading rates (315 ± 13 mgNO2−-N/(l.d)), using a chemical oxygen demand (COD) to nitrogen ratio of 18 gCOD/gNO2−-N, and an organic loading rate of 5.4 ± 0.2 gCOD/(l.d). In parallel, the effects of sludge morphology on methanogenesis inhibition were studied by performing short-term batch activity tests at different COD/NO2−-N ratios with anaerobic sludge samples. In long-term tests, denitrification was practically complete and COD removal efficiency did not change significantly after nitrite addition. Furthermore, methane production only decreased by 13%, agreeing with the reducing equivalents requirement for complete NO2− reduction to N2. Apparently, the spatial separation of denitrification and methanogenesis zones inside the UASB reactor allowed nitrite reduction and methanogenesis to occur at the same moment. Batch tests showed that granules seem to protect methanogens from nitrite inhibition, probably due to transport limitations. Combined COD and N removal via nitrite in a single-stage UASB reactor could be a feasible technology to treat high-strength domestic wastewater.