Biological　nitrogen　removal　from　pharmaceutical　wastewater　has　drawn　increasing　attention　due　to　biotoxicity　and　inhibition.　In　this　study,　for　the　first　time,　a　novel　approach　integrating　partial-denitrification　with　anaerobic　ammonia　oxidation　(PD/A)　in　a　sequencing　biofilm　batch　reactor　(SBBR)　was　proposed　and　demonstrated　to　be　efficient　to　treat　the　bismuth　nitrate　and　bismuth　potassium　citrate　manufacturing　wastewater,　containing　ammonia　(NH4+-N)　and　nitrate　(NO3-　-N)　of　6300　+/-　50　mg　L　-1　and　15,300　+/-　50　mg　L　-1.　The　maximum　anammox　activity　was　found　at　the　shock　effect　of　influent　total　nitrogen　(TN)　of　100　mg　L　-1　with　NO3-　-N/NH4+-N　of　1.0.　Long-term　operation　demonstrated　that　the　PD/A　biofilm　was　developed　rapidly　after　30　days　using　synthetic　influent,　with　TN　removal　efficiency　increasing　from　40.9%　to　80.8%.　Significantly,　the　key　bacteria　for　PD/A　had　high　tolerance　and　adapted　rapidly　to　pharmaceutical　wastewater,　achieving　a　relatively　stable　TN　removal　efficiency　of　81.2%　with　influent　NH4+-N　and　NO3-　-N　was　77.9　+/-　2.6　and　104.1　+/-　4.4　mg　L　-1　at　a　relatively　low　COD/NO3-　-N　of　2.6.　Anammox　pathway　contributed　to　TN　removal　reached　83.6%.　Significant　increase　of　loosely-bound　extracellular　polymeric　substances　was　obtained　with　increasing　protein　of　3-turn　helices　structure　as　response　to　the　inhibitory　condition.　High-throughput　sequencing　analysis　revealed　that　the　functional　genus　Thauera　was　highly　enriched　in　both　biofilms　(9.5%-*43.6%)　and　suspended　biomass　(15.5%-*57.5%),　which　played　a　key　role　in　high　NO2-　-N　accumulation.　While　the　anammox　bacteria　decreasing　from　7.8%　to　1.6%　in　biofilm,　and　from　1.8%　decreased　to　0.1%　in　the　suspended　sludge.　Overall,　this　study　provides　a　new　method　of　high-strength　pharmaceutical　wastewater　treatment　with　low　energy　consumption　and　operation　cost,　as　well　as　a　satisfactory　efficiency.