PN/Anammox, as an economical and effective nitrogen removal process, is of great significance for reducing carbon emission in municipal wastewater treatment. However, municipal wastewater has mainstream characterized of low temperature and low NH4+-N concentration, and NOB activity is difficult to inhibit, so achieving a stable PN process is the biggest challenge in the application of PN/Anammox to mainstream wastewater. This study developed a method for stable and efficient PN/Anammox based on very low sludge volume (MLVSS = 65 mg/L). Even when the temperature dropped to 15℃ or there was exogenous nitrite-oxidizing bacteria (NOB) interference, the system still had good inhibition of NOB activity. The total stable operation time was 386 days, and the NO2–-N accumulation efficiency could reach more than 90 %. Ellin6067, Nitrosomonas and Candidatus_Brocadia were the dominant functional microorganisms in the system. Nitrospira was the dominant genera of NOB with very low relative abundance (<0.04 %). The mechanism of the long-term stable mainstream PN/Anammox system showed that low sludge content was beneficial to light irradiation on microorganisms in the reactor, while nxrA, the functional gene of NOB, had weak light resistance and oxidation resistance, which makes the system had strong inhibition effect on NOB. The construction of this new system which does not depend on activated sludge volume and complex NOB activity inhibition strategy can better promote the practical application of PN/Anammox under mainstream conditions.