The removal of dissolved organic matter (DOM) from seawater before the reverse osmosis (RO) processes is crucial for alleviating organic fouling of RO membranes. However, research is still insufficiently developed in the comparison of the effectiveness of integrating coagulation with ultrafiltration (UF) or sand filtration (SF) in the pretreatment stage of seawater reverse osmosis (SWRO) for the removal of DOM. In this study, we investigated the effect of pretreatment technologies on RO fouling caused by DOM in seawater, including the integration of coagulation and sand filtration (C-S pretreatment) and the integration of coagulation and ultrafiltration (C-U pretreatment). Both integrated pretreatments achieved comparable DOM removal rates (70.2% for C-U and 69.6% for C-S), and C-S exhibited enhanced removal of UV-absorbing compounds. Although C-U was more proficient in reducing the silt density index (below 2) compared to C-S (above 3) and improved the elimination of humic acid-like organics, it left a higher proportion of tyrosine-protein-like organics, soluble microbial by-product-like organics, and finer organics in the effluent, leading to the formation of a dense cake layer on RO membrane and a higher flux decline. Therefore, suitable technologies should be selected according to specific water conditions to efficiently mitigate RO membrane fouling.