With the aim of improving knowledge about the stability and reliability of anaerobic wastewater treatment systems, several researchers have studied the effects of operational or environmental variations on the performance of such reactors. In general, anaerobic reactors are affected by changes in external factors, but the severity of the effect is dependent upon the type, magnitude, duration and frequency of the imposed changes. The typical responses include a decrease in performance, accumulation of volatile fatty acids, drop in pH and alkalinity, change in biogas production and composition, and sludge washout. This review summarises the causes, types and effects of operational and environmental variation on anaerobic wastewater treatment systems. However, there still remain some unclear technical and scientific aspects that are necessary for the improvement of the stability and reliability of anaerobic processes.