Biological nitrogen (N) removal with the bio-media process has been the preferred technology and recent developments in this technology have focused on improving N removal. However, integrated fixed film activated sludge, external nitrification, membrane, aerobic granulation BNR systems and more efficient N removal bioprocesses have been developed nowadays. To achieve N removal more efficiently, methods of nitrification and denitrification have been developed by preventing nitrate formation and enforcing nitrification-denitrification over nitrite. The process requires less oxygen and organics than nitrification-denitrification over nitrate allowing lower N concentrations to be achieved for the same influent organic’s concentration and oxygen supply. Biological filtration process using the bio-media technique that utilizes micro-organisms to remove nutrients from the wastewater. A recent study has been shown that various bio-media efficiently used for the nitrification-denitrification process, also the growth of biofilm is the potential for ammonia removal. Moreover, this technology applies to a wide range and effective in removing up to 90-95% nutrients from the effluents. Therefore, the specific surface area of bio-media is available for bio-film growth depends on media types. The main purpose of this review paper is to study the application and performance of different bio-media and their removal efficiency using biological biofilm process.