The nitrogen species in wastewater was different according to the source of wastewater. In addition, the posttreatment of effluent after anammox process is needed for the high-strength wastewater. Therefore, the actual application of anammox technology needs the cooperation with other the pretreatment process or posttreatment process. Therefore, many anammox-based processes were developed, like the partial nitritation/anammox process, denitratation-anammox process, Damo-anammox process, and so on. This chapter will review these main anammox-based process.