Sewer system design must be integrated with wastewater treatment plant design when moving towards a more sustainable urban wastewater management. This integration allows an optimization of the design of both systems to achieve a better and more cost-effective wastewater management. Hitherto integrated process design has not been an option because the tools to predict in-sewer wastewater transformations have been inadequate. In this study the WATS model--being a new and validated tool for in-sewer microbial process simulations--is presented and its application for integrated sewer and treatment plant design is exemplified. A case study on a Malaysian catchment illustrates this integration. The effects of centralization of wastewater treatment and the subsequently longer transport distances are addressed. The layout of the intercepting sewer is optimized to meet the requirements of different treatment scenarios.