In the frame of the European FP6 project Neptune, a combination of biological activated carbon with ultrafiltration (BioMAC) was investigated for micropollutant, pathogen and ecotoxicity removal. One pilot scale set-up and two lab-scale set-ups, of which in one set-up the granular activated carbon (GAC) was replaced by sand, were followed up during a period of 11 months. It was found that a combination of GAC and ultrafiltration led to an almost complete removal of antibiotics and a high removal (>80%) of most of the investigated acidic pharmaceuticals and iodinated contrast media. The duration of the tests did however not allow to conclude that the biological activation was able to extend the lifetime of the GAC. Furthermore, a significant decrease in estrogenic and anti-androgenic activity could be illustrated. The set-up in which GAC was replaced by sand showed a considerably lower removal efficiency for micropollutants, especially for antibiotics but no influence on steroid activity.