In this study, the side-stream heat-shock treatment was used to start up and maintain the nitritation of real sewage. Complete nitrification was obtained when the real sewage was treated in a sequencing batch reactor (SBR). Then, about 50% of the mixed sludge was collected from the SBR and treated with the heat-shock treatment at 60 °C for 40 min in another reactor every 2 weeks. After providing the heat-shock treatment for four times, the effluent nitrate in the SBR gradually decreased from 22.5 to 3.2 mg/L, while the nitrite accumulation rate increased from 4.4% to 81.8%, indicating a successful start-up of nitritation. Further, the sewage nitritation was stable with the regular side-steam heat-shock treatment for 91 days, and the ammonium removal efficiency of 80.6% and nitrite accumulation rate of 91.2% were achieved. This study suggests that the side-stream heat-shock treatment could be used to start up sewage nitritation and maintain stability for a long-term operation.