The membrane bioreactor (MBR) process synergistically combines biological treatment with membrane filtration, offering a compact design and enhanced operational flexibility. However, membrane fouling remains a critical bottleneck, limiting its widespread application, particularly in treating high-strength wastewater. Recent advances have demonstrated that integrating MBR systems with auxiliary processes such as adsorption, electrochemical treatments, algal-assisted systems, and others can significantly mitigate fouling and enhance treatment efficacy. This paper critically reviews various MBR hybrid configurations, examining their mechanisms, advantages, and limitations in terms of treatment performance and fouling control, while highlighting their potential to extend conventional MBR's applicability to challenging wastewaters and addressing operational challenges like economic viability and sustainability. Elaborated tables incorporating a wide variety of research studies within the realm of synchronization have been meticulously compiled to generate a comprehensive literature review.
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