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Wastewater from Binh An hospital was treated by EGSB lab-scale model. It is found that both EGSB started up with granular sludge and septic sludge operated at organic loading rate of 0.2-1.8 kg COD/m 3 .day, with upward-flow velocity of 1.3 m/h can achieve greater than 65% COD removal efficiency and meet the current Vietnamese discharged standard for effluent from hospital wastewater (QCVN 28:2008/BTNMT). COD decreased from 148 ± 18 mg/L of the influent to 50 ± 18 mg/L of the effluent and BOD 5fatcat:dt2p35na4bernjlvkwfcxqvzci