The suspended solids (SS) concentrations in effluent from moving bed biofilm reactors (MBBRs) used for secondary biological treatment can be up to 500 mg/L. Microscreens (Drumfilters or Discfilters) can be used as alternatives to traditional clarification or dissolved air flotation to remove SS and total phosphorus (TP). This study shows how a small-scale municipal WWTP for 5,700 population equivalent (PE) can be upgraded to 12,000 PE by combining MBBR with coagulation-flocculation tanks and a Discfilter with a total footprint of 160 m2. This long-term investigation demonstrated that even though influent turbidity (range 146–431 NTU) and flow (25–125 m3/h) varied considerably, very low effluent turbidities (below 10 NTU) could be achieved continuously. Furthermore, this compact treatment system can provide average reductions of ammonium (NH4-N) from 19 to 0.04 mg/L, COD from 290 to 10 mg/L, and TP from 4.5 to 0.3 mg/L. The results show that effluent requirements can be reached by combining MBBR, coagulation-flocculation and disc filtration at full-scale, without a primary clarifier upstream of MBBR.