A pilot-scale study on sludge treatment reed beds investigated the combined effects of earthworms and Arundo donax on sewage sludge dewatering and residual sludge quality. Four units were tested: one planted with earthworms, one planted without earthworms, one unplanted with earthworms, and one control, each unit replicated. Over a year, 24 cycles of sludge (dry and volatile solid contents of 24.71 g.L−1, and 19.14 g.L−1) were fed onto the units at a sludge loading rate: 43.59 kg.DS.m−2.year−1. Afterward, the units experienced 132 days of resting period, increasing dry solids from 21 to 70 % and decreasing volatile solids from 81 to 69 % on average (40 % sludge volume reduction). The bottom layers of the planted unit with earthworms showed a 30 % reduction in volatile solids, indicating improved sludge stabilization. Macronutrient abundance in the residual sludge followed the sequence N > Ca > P > K > S > Mg. The planted unit with earthworms reduced micronutrient concentrations by 22 % compared to the control unit (Fe > Na > Mn > B > Mo). Earthworms also played a key role in reducing heavy metal concentrations by 11 % compared to the planted unit without earthworms (Zn > Cr > Pb > Ni > Cd). Heavy metal levels in the residual sludge met EU and Portugal standards, with a 99.9 % reduction in Escherichia coli and fecal coliforms. Cost estimation showed centrifugation and W-STRB scenarios cost 167 and 183 €.PE−1 for a ten-year operation, with O&M costs of 7 and 3 €.PE−1.year−1, respectively.