Increase of shear stress at membrane surfaces is a generally applied strategy to minimize membrane fouling. It has been reported that a two-phase flow, better known as slug flow, is an effective way to increase shear stress. Hence, slug flow was introduced into an anaerobic membrane bioreactor for membrane fouling control. Anaerobic suspended sludge was cultured in an anaerobic membrane bioreactor (AMBR) operated with a side stream inside-out tubular membrane unit applying sustainable flux flow regimes. The averaged particle diameter decreased from 20 to 5 microm during operation of the AMBR. However, the COD removal efficiency did not show any significant deterioration, whereas the specific methanogenic activity (SMA) increased from 0.16 to 0.41 gCOD/g VSS/day. Nevertheless, the imposed gas slug appeared to be insufficient for adequate fouling control, resulting in rapidly increasing trans membrane pressures (TMP) operating at a flux exceeding 16 L/m2/h. Addition of powdered activated carbon (PAC) enhanced the effect of slug flow on membrane fouling. However, the combined effect was still considered as not being significant. The tubular membrane was subsequently equipped with inert inserts for creating a locally increased shear stress for enhanced fouling control. Results show an increase in the membrane flux from 16 L/m2/h to 34 L/m2/h after the inserts were mounted in the membrane tube.