The performance of a vertical flow constructed wetland for combined sewer overflow treatment (CSO CW) has been evaluated. The full-scale site has been monitored for 3 years for major pollutants and for two load events for a range of micropollutants (metals, metalloids and polycyclic aromatic hydrocarbons (PAHs)). Performance were predominantly high (97% for total suspended solids (TSS), 80% for chemical oxygen demand (COD), 72% for NH4-N), even if several loads were extremely voluminous, pushing the filter to its limits. Two different filter materials (a 4:1 mixture of sand and zeolite and natural pozzolana) showed similar treatment performance. Furthermore, environmental factors were correlated with COD removal efficiency. The greatest influencers of COD removal efficiency were the inlet dissolved COD concentrations and the duration and potential evapotranspiration during inter-event periods. Furthermore, sludge was analysed for quality and a sludge depth map was created. The map, and calculating the changes in sludge volume, helped to understand solid accumulation dynamics.