Reclamation and reuse of wastewater is one of the most effective ways to alleviate water resource scarcity. In many countries very stringent limit for chlorination by-products such as trihalomethanes has been set for wastewater reuse. Accordingly, the use of alternative oxidation/disinfection systems should be evaluated as possible alternative to chlorine. Recently ultrasound (US) was found to be effective as pre-treatment for wastewater disinfection by UV irradiation. The aim of this work is to investigate the wastewater advanced treatment by simultaneous combination of UV and US in terms of bacteria inactivation (Total coliform and Escherichia coli) at pilot-scale. The pilot plant was composed of two reactors: US-UV reactor and UV reactor. The influence of different reaction times, respective US and UV dose and synergistic effect was tested and discussed for two different kinds of municipal wastewater. An important enhancement of UV disinfection ability has been observed in presence of US, especially with wastewater characterized by low transmittance. In particular the inactivation was greater for T. coliform than for E. coli. Furthermore, the results obtained showed also that the fouling formation on the lamps was slower in US-UV reactor than in UV reactor both with and without solar radiation.