An integrated chemical-physical-biological treatment concept for the low-cost treatment of domestic wastewater is proposed. Domestic wastewater was subjected to a chemically enhanced primary treatment (CEPT), followed by treatment in an upflow anaerobic sludge blanket (UASB) reactor. In addition, a regenerable zeolite was used to remove NH4+, either after CEPT pretreatment or after biological treatment in the UASB reactor. The CEPT pretreatment consisted of the addition of a coagulant (FeCl3) and an anionic organic flocculant and removed on average 73% of the total chemical oxygen demand (COD(t)), 85% of the total suspended solids, and 80% of PO4(3-) present in the wastewater. The UASB system, which consequently received a low COD(t) input of approximately 140 mg/L, was operated using a volumetric loading rate of 0.4 g COD(t)/L. d (hydraulic retention time [HRT]=10 h) and 0.7 g COD(t)/L. d (HRT=5 h). For these conditions, the system removed about 55% of the COD(t) in its influent, thus producing an effluent with a low COD(t) of approximately 50 mg/L. The zeolite, when applied in batch mode before the UASB reactor, removed approximately 45% of the NH4+, whereas its application as a post-treatment cartridge resulted in almost 100% NH4+ removal. The simple design and relatively low operating costs, due to low costs of added chemicals and low energy input (estimated at Euro 0.07-0.1 per m3 wastewater treated), combined with excellent treatment performance, means that this system can be used as a novel domestic wastewater treatment system for developing countries. Therefore, the system is called a Low Investment Sewage Treatment (LIST) system.