This comprehensive review discusses diverse conventional and novel technologies for nitrogen removal from wastewater. Novel technologies have distinct advantages in terms of saving configuration, aeration, and carbon sources. Each novel technology possesses promising features and potential problems. For instance, SND and OLAND processes can achieve 100% total nitrogen removal, but the low oxygen concentration required by these two processes substantially reduces the nitrification rate, which limits their application. On the other hand, denitrification can still be carried out by aerobic denitrifiers at high DO levels in activated sludge process, but it is difficult to cultivate this type of bacteria. The SHARON process is most commonly used for shortcut nitrification and denitrification because of its low requirements for retention time, oxygen concentration, and carbon source. However, its high operational temperature (about 35 degrees C) limits the application. Several real-time control strategies (DO, pH, and ORP) have been developed to achieve a stable nitrite accumulation in SHARON. The ANAMMOX process can sustain at high total-N loadings and has been employed in full-scale treatment plants, but the problem of nitrite supply has not been solved, and the treated wastewater still contains nitrate. In addition, the inoculation and enrichment of ANAMMOX bacteria (i.e., anaerobic AOB) is difficult. The problem of nitrite supply has been solved by combining partial nitrification with ANAMMOX, which provides abundant nitrite for anaerobic AOB. ANAMMOX is currently used for treating sludge digestion supernatant. Aerobic dammonitrification is a process combining partial nitrification and ANAMMOX at different layers of biofilm. Although the technology has been tested in pilot- and full-scale experiments, the mechanism is still unclear. CANON and OLAND are one-step ammonium removal processes that possess distinct advantages of saving carbon sources and aeration costs. The major challenge is the enrichment of anaerobic microorganisms capable of oxidizing ammonia with nitrite as the electron acceptor. Molecular biology and environmental biotechnology can help identify functional microorganisms, characterize microbial communities, and develop new nitrogen removal processes. Extensive research should be conducted to apply and optimize these novel processes in wastewater treatment plants. More effort should be invested to combine these novel processes (e.g., partial nitrification, ANAMMOX) to enhance nitrogen removal efficiency.