Biosolid management is becoming one of the most crucial issues for wastewater treatment plant (WWTP) operators. The application of the Oxic Settling Anaerobic (OSA) process allows the minimisation of excess sludge production. This study compares conventional activated sludge (CAS) and OSA layouts in a full-scale WWTP (namely, Corleone - Italy). Extensive monitoring campaigns were conducted to assess treatment performances regarding carbon and nutrient removal, greenhouse gas (GHG) emissions, excess sludge production, and biomass activity (by means of respirometric analysis). Results showed that the effluent quality consistently met the Italian discharge limits. However, with the implementation of the OSA process, there was a decrease in ammonium removal efficiency, which could be attributed to reduced nitrifier activity related to reduced biomass production and extended anaerobic conditions affecting the nitrification process. On the other hand, the OSA configuration significantly increased phosphorus removal, indicating a high phosphorus content in the resulting waste sludge. A worsening of the sludge settling properties was observed with the OSA configuration likely due to decreased EPS concentrations. The sludge production in the OSA configuration decreased by 17.3 % compared to CAS. Nitrous-oxide measurements did not show a variation between CAS and OSA configurations, confirming that the OSA process can be a suitable solution for reducing WWTP's carbon footprint.