Iodinated X-ray contrast media have been detected in hospital effluent, sewage treatment plant effluent, rivers and groundwater aquifers. No process has been developed to remove triiodinated aromatic molecules. In this paper, we present a biological sequential process using an anaerobic fixed-bed reactor coupled in series with an aerobic fixed-bed reactor for degrading 5-amino-2,4,6-triiodoisophthalic acid (ATIA), the core structure of a X-ray contrast media family. The results obtained showed that the coupled reactor eliminated up to 870+/-44 mg of carbon L(-1) day(-1), with a molar ethanol/ATIA ratio of 4 in the feeding medium. The anaerobic reactor (ANR) undertook the majority of the deiodination of the aromatic nucleus and had a maximum deiodination rate of 23.4+/-0.06 mM day(-1). The aerobic reactor (AER) mineralized ATIA and was also able to eliminate its metabolites. This study suggests that the mineralization of ATIA can be achieved efficiently in a coupled anaerobic-aerobic bioreactor.