Decentralized membrane-based water treatment represents an attractive and viable approach to safe water supply in low-income areas, but its widespread adoption requires cost-effective antifouling strategies. Although the antifouling mechanisms of Al-based coagulants have been widely investigated, there is little data about their impact on costs and treatment efficiency for decentralized membrane-based systems. In this study, a comparative assessment of two decentralized ultrafiltration (UF) units with and without polyaluminum chloride (PACl) coagulation was undertaken to evaluate the influence of coagulation on fouling, water quality, and costs nexus. The results showed that PACl suppressed both total fouling and hydraulically irreversible fouling. A matched-pair analysis also revealed that PACl improved the permeate quality by enhancing the removal of particulates and dissolved organics. Compared to the conventional UF system, the hybrid coagulation-UF system contributed to a 21% increase in the flux rate, allowing for a 27% reduction in membrane area and thus, providing cost benefits in terms of both capital and operating costs. These results suggest that PACl coagulation is potentially a cost-effective antifouling method for decentralized membrane-based water systems.