Membrane distillation (MD) is regarded as a promising technology for treatment of landfill leachate membrane concentrate (LLMC) due to its merits of low cost and high rejection of non-volatile components. However, the high concentration of pollutants in the wastewater will cause severe membrane fouling, resulting in costly cleaning and maintenance. In this study, Fenton pretreatment was applied to alleviate membrane fouling during MD treatment of LLMC. Compared to rapid flux decline of 88.2% at concentration factor (CF) of 3 for raw LLMC, MD flux only decreased by 17.4% at CF = 6 for treating acidic Fenton effluent without subsequent pH adjustment (Fe2+ and H2O2 concentration were 600 mg/L and 1457 mg/L, respectively). The pH neutralization of Fenton effluent or merely acidification of LLMC could not achieve such excellent fouling mitigation. It was concluded that both oxidation and acidification were critical and the collaboration mechanism was revealed to explain low membrane fouling. Firstly, Fenton oxidation removed organic contaminants, reduced the hydrophobicity of organic substances and increased the percentage of carboxylic group within LLMC. Thus, hydrophobic (HP) attraction was weakened but multivalent cation bridging became dominant fouling mechanism for neutral Fenton effluent. Then, acidification weakened multivalent cation bridging by inhibiting the deprotonation of carboxylic group, further mitigating membrane fouling. However, acidification of LLMC caused more severe organic fouling due to decrease in electrostatic (EL) repulsion. In addition to low membrane fouling, satisfactory total organic carbon (TOC) rejection rate of 96.23% was achieved during combined Fenton-MD process. This study demonstrated that Fenton pretreatment without pH neutralization could effectively alleviate MD fouling and elucidated the synergistic mechanism between oxidation and acidification for fouling mitigation.