The present study summarizes the start-up performance and lessons learned during the start-up and optimization of a pilot-scale plant employing integrated fixed film activated sludge (IFAS) process treating actual municipal wastewater. A comprehensive start-up was tailored and implemented to cater for all the challenges and problems associated with start-up. After attaining desired suspended biomass (2,000-3,000 mg/L) and sludge age (∼7 days), the average biological oxygen demand (BOD) and chemical oxygen demand (COD) removals were observed as 77.3 and 70.9%, respectively, at optimized conditions, i.e. hydraulic retention time (HRT), 6.9 h; return sludge rate, 160%. The influent concentrations of COD, BOD, total suspended solids, NH3-N, total nitrogen and total phosphorus were found to be in the range of 157-476 mg/L, 115-283 mg/L, 152-428 mg/L, 23.2-49.3 mg/L, 30.1-52 mg/L and 3.6-7.8 mg/L, respectively, and the minimum effluent concentrations were achieved as ∼49 mg/L, 23 mg/L, 35 mg/L, 2.2 mg/L, 3.4 mg/L and 2.8 mg/L, respectively, at optimum state. The present system was found effective in the removal of pathogenic bacteria (Escherichia coli, 79%; Salmonella spp., 97.5%; Shigella spp., 92.9%) as well as coliforms (total coliforms, 97.65%; faecal coliforms, 80.35%) without any disinfection unit. Moreover it was observed that the time required for the stabilization of the plant was approximately 3 weeks if other parameters (sludge age, HRT and dissolved oxygen) are set to optimized values.