The treatment of ammonium rich wastewater, like sludge digester effluent, can be significantly improved when new biotechnological processes are introduced. In this paper, the combination of a partial nitrification process (SHARON) and anoxic ammonium oxidation (Anammox) process for the treatment of ammonia rich influents is evaluated. Herein the combined process has been studied with sludge recycle liquor from the WWTP Rotterdam-Dokhaven. The SHARON process was operated stably for more than 2 years in a 10ICSTR under continuous aeration with a HRT of 1 day. The ammonia in the sludge liquor was converted by 53% to nitrite only. During the test period no formation of nitrate was observed. The effluent of the SHARON process was ideally suited as influent for the Anammox reactor. The Anammox process was operated as a granular sludge SBR-process. More than 80% of the ammonia was converted into dinitrogen gas at a load of 1.2 kgN/m3 per day. Planctomycete-like bacteria dominated the mixed community of the Anammox reactor, and only a small percentage of the population consisted of aerobic ammonium-oxidizing bacteria. This showed that the ammonium-oxidizers in the effluent of the SHARON process did not accumulate in the SBR. The test period showed that the combined SHARON-Anammox system can work stably over long periods and the process is ready for full-scale implementation.