An oxic–settling–anaerobic process (OSA) can effectively reduce sludge production, but most of the research studies on the OSA process have been either under laboratory test conditions or based on synthetic wastewater, which cannot fully reflect the performance and sludge reduction efficiency in existing OSA process. Thus, aiming at examining the sludge reduction efficiency and the stability of the OSA process, UNITANK and UNITANK–OSA processes were performed in a 120 m3/d pilot-scale system using actual sewage. The results indicate that UNITANK–OSA achieved a 48% reduction of the sludge compared to the reduction due to UNITANK, not considering the accumulation of the effluent-suspended solids. The effluent quality was not found to change significantly, except that the total phosphorus concentration increased slightly. The extracellular polymeric substances metal floc theory may, to some extent, explain this reduction in this study. The OSA process could be used to reform the classic wastewater treatment process to get lower sludge mass.