Enhancement of anaerobic ammonium oxidation (anammox) process and enrichment of anammox bacteria in the oxic zone of mainstream sewage treatments are complex. Also, quantification of the anammox contribution for nitrogen removal in the oxic zone is hindered owing to the simultaneous occurrence of anammox and nitrification. An alternating anaerobic/oxic/anoxic/oxic bioreactor whose oxic zone boosted partial nitrification coupling anammox (PN/A) and anoxic zone boosted partial denitrification coupling anammox (PD/A), respectively, was operated to treat real sewage for >380 days. Desirable nitrogen removal (effluent total inorganic nitrogen (TIN) of 4.7 ± 1.9 mg N/L) was obtained from low carbon/nitrogen (3.6 ± 0.5) sewage with ammonium concentration of 52.5 ± 2.2 mg N/L in the influent. Under the condition of dissolved oxygen (DO) of 1.5–3 mg/L, anammox bacteria was still enriched within the aerobic biofilms, with the relative abundance increasing to 8.2 % (day 345) from 0 % (no biomass on day 1), which was higher than the value in the flocculent sludge (0.03 %) (P < 0.001). PN driven by flocculent sludge with high activity of ammonium oxidized bacteria (AOB) ensured sufficient nitrite supply for the anammox process with the existence of continuous DO. During the steady operation period, the maximum anammox contribution in the oxic zone was quantified to be 10.6 % by withdrawing aerobic biofilms from the system.