Total nitrogen (TN) removal by sewage treatment required the development of nitrifying and denitrifying activities; however, these metabolite activities can produce and emit nitrous oxide (N2O), one of the greenhouse gases (GHG). With the expansion of sewage treatment in the world, compact systems such as moving bed biofilm reactor (MBBR) may be promising, mainly in more populated cities. However, little is known about N2O emission by the MBBR. This work investigated the N-NHx and TN removal, N2O production and emission and nitrogen mass balance in a MBBR under organic load and airflow variation. The highest TN removal (47%) was observed under higher load and higher aeration rate. Meanwhile, the MBBR under lower load and lower airflow had the lowest efficiency of TN and N-NHx removal probably due to a lower nitrifying activity. The N2O emission factors were lower than 1.6% (value estimated by the IPCC for sewage aerobic treatment systems). In addition, in the essay with higher load and lower airflow, half of removed TN was released by settled sludge and there is little research about this subject. Therefore, the MBBR showed to be a promising process for nitrogen removal with little emission of N2O even under different operational conditions that normally can occur in sanitary sewage system in cities around the world.