Treatment wetlands have been used for decades to treat wastewaters with low organic strength, but little information is available on the treatment of wastewaters with high organic strength. The objective of this study was to evaluate the efficiency of a vertical flow wetland in the primary treatment of synthetic wastewater with medium organic strength (1976 mg COD/L). Alternatives in the reuse of the resulting treated wastewater were also considered. The wetland consisted of several layers of sand and gravel of different granulometry and was planted with the helophyte Eryngium horridum, a species rarely used in treatment wetlands. The wetland was fed with synthetic wastewater by a single feed pulse, with a hydraulic retention time of 24 h. The treatment removed 81% of TSS and 70% of COD. The concentrations of ammonium nitrogen and soluble reactive phosphorus increased due to partial mineralization of organic matter. Total phosphorus and total nitrogen removal were 28% and 5%, respectively. Wastewater suitability for reuse in irrigation increased after treatment. However, a later stage is recommended to further reduce COD and nutrient concentration and disinfect the water.