Pressure enhanced coagulation and sedimentation technique is an effective way for blue algae treatment. It is not clear whether Cyanobacteria balloon rupture will cause Cyanobacteria cells rupture, resulting in high intracellular concentrations of microcystin LR leak into the water, affecting drinking water safety. Therefore, in this study experimental comparative study of pressure and pre-oxidation of water containing Cyanobacteria was carried out to examine the microcystin LR concentration changes and Cyanobacteria removal efficiency. The results showed that microcystin concentration increase was not significant by the pre-treatment with Cyanobacteria water pressure, while the pre-oxidation process caused a significant increase in the concentration of microcystin. After 0.5-0.8 MPa pressure coagulation and sedimentation, removal of Cyanobacteria basically was over 90%, up to 93.5%, while the removal rate by pre-oxidation was low and unstable. Effluent turbidity is also significantly better in the pre-pressure method than the pre-oxidation. The results indicated that pressure enhanced coagulation is a safe and reliable method for Cyanobacteria removal.