An amphoteric starch-based flocculant 3-chloro-2-hydroxypropyltrimethyl chloride modified carboxymethyl starch (CMSCTA) for sludge dewatering was prepared and evaluated as a potential greener and economical alternative to conventional flocculants. A novel method of combining carbon skeleton (synthetic fiber) with flocculant conditioned sludge for enhancing the sludge dewaterability was also studied. With the combined treatment using CMSCTA and polyester fiber (PET), the sludge moisture content decreased to 64.4 % from 96.5 % and the optimal filtration rate was 2.92 mL∙min−1. The amphoteric flocculant optimized the substitution degree of anionic and cationic groups, which was shown the CMSCTA improved dewatering performance by promoting the release of nitrogen-containing substances and maintaining a more stable floc particle size distribution span. The results suggested an adsorption bridging occurred in addition to charge neutralization. The anionic groups in the amphoteric flocculants inhibited the complete adsorption of the flocculants (tight link), increasing the possibility of establishing a bridge between the flocculants and multiple sludge particles. The mercury intrusion experiments showed the porosity of sludge increased from 9.9 % to 12.8 % after the combined treatment, where PET facilitated sludge dewatering by providing moisture channels and a rigid skeleton. Charge neutralization, inhibition of complete adsorption, and construction of skeletons and moisture channels are the main mechanisms of sludge dewatering by the combined conditioning of amphoteric starch-based flocculators and fibers. This study explored the synergistic effect of starch-based modified flocculants and fibers, which has important guiding significance for improving the dewatering performance of sludge.