Anaerobic　ammonium　(NH4+　-　N)　oxidation　coupled　with　sulfate　(SO42−)　reduction　(sulfammox)　is　a　new　pathway　for　the　autotrophic　removal　of　nitrogen　and　sulfur　from　wastewater.　Sulfammox　was　achieved　in　a　modified　up-flow　anaerobic　bioreactor　filled　with　granular　activated　carbon.　After　70　days　of　operation,　the　NH4+　-　N　removal　efficiency　almost　reached　70%,　with　activated　carbon　adsorption　and　biological　reaction　accounting　for　26%　and　74%,　respectively.　Ammonium　hydrosulfide　(NH4SH)　was　found　in　sulfammox　by　X-ray　diffraction　analysis　for　the　first　time,　which　confirmed　that　hydrogen　sulfide　(H2S)　was　one　of　the　sulfammox　products.　Microbial　results　indicated　that　NH4+　-　N　oxidation　and　SO42−　reduction　in　sulfammox　were　carried　out　by　Crenothrix　and　Desulfobacterota,　respectively,　in　which　activated　carbon　may　operate　as　electron　shuttle.　In　the　15NH4+　labeled　experiment,　30N2　were　produced　at　a　rate　of　34.14　μmol/(g　sludge·h)　and　no　30N2　was　detected　in　the　chemical　control　group,　proving　that　sulfammox　was　present　and　could　only　be　induced　by　microorganisms.　The　15NO3−　labeled　group　produced　30N2　at　a　rate　of　88.77　μmol/(g　sludge·h),　demonstrating　the　presence　of　sulfur-driven　autotrophic　denitrification.　In　the　adding　14NH4+　and　15NO3−　group,　it　was　confirmed　that　NH4+　-　N　was　removed　by　the　synergy　of　sulfammox,　anammox　and　sulfur-driven　autotrophic　denitrification,　where　the　main　product　of　sulfammox　was　nitrite　(NO2−)　and　anammox　was　the　main　cause　of　nitrogen　loss.　The　findings　showed　that　SO42−　as　a　non-polluting　species　to　environment　may　substitute　NO2−　to　create　a　new　“anammox”　process.　©　2023　Elsevier　Inc.