An electrochemical floatation system (EFS)-based sewage-treatment process that applied a dimensionally stable anode (DSA) was developed to secure treated sewage water from sewage-treatment plants for reuse. The DSA was fabricated at a temperature of 673–923 K by dispersing a low quantity of activated carbon on a titanium plate coated with mixed metal oxides (Pt, Re, Pd, Re, and Ir) to a thickness of 5 μm. The average size of the bubbles generated through the DSA of the EFS was 20–40 μm, thus confirming microbubble generation. An efficiency assessment of a titanium-based DSA confirmed metal oxide activity through the removal of Escherichia coli (100%) and total organic carbon (TOC; 48.83%) at a reaction time shorter than 10 min and a low current density (19.6 A/m2). During the long-term operation of the EFS with the separation membrane process, the average removal efficiency was 94.7%, 90.0%, 96.1%, 90.9%, and 98.0% for suspended solids, biochemical oxygen demand, TOC, total nitrogen, and total phosphorous, respectively. Coliforms were not detected. Overall, our EFS coupled with the separation membrane process produced high-quality recycled water that could be used for various purposes according to the water-quality standards for different applications.