There is a need to improve the efficiency of the existing sanitary treatment facilities, because the effluent standard becomes more stricter and septic sludge increased. Thus, operating processes of sanitary treatment system in M city changed with installation of additional facilities. Process modifications were as follows: Dilution water was added to the next process after primary aeration tank. Some secondary sedimentation sludge was recycled to primary aerator so that most of the organics were stabilized in primary aeration tank under automatic control of dissolved oxygen. The line of effluent from dewatering process flowing to the activated sludge tank was changed to the primary aerator. The primary sedimentation sludge line was linked to a thickener. Polymer was added to the activated sludge tank. The effluent of primary aerator and aerobic digester was recycled from the 5th to the 1st sector. As consequencies of above process modifications, the improvement of removal efficiency was achieved as BOD 54%, COD 42%, SS 61%, T-N 39%, and T-P 12%, respectively.