The application of the mainstream partial nitritation/anammox (PN/A) process is promising due to the huge cost reduction compared to traditional biological nitrogen removal. However, the nitrite production rate (NPR) of a biological nitritation pre-treatment process is relatively lower than the nitrite consumption rate in a pure anammox reactor with a high nitrogen loading rate (NLR). Thus, the NPR is the rate-limiting step for operating the PN/A process with a higher NLR. Various studies have attempted to improve mainstream NPR. A comprehensive review of these processes is needed for the actual application of the PN/A process. This study focuses on: (1) various nitrite production processes that have emerged in recent years; (2) the main microbial species and characteristics involved in biological nitritation; (3) the existing problems and the N2O emission problem of these processes; and (4) a proposed novel and promising PN/A process facilitated with photocatalyst oxidation. This review is expected to provide references and a basis for the research on the nitritation step of the application of the mainstream PN/A process.