Microbial fuel cells (MFCs) are a promising technology for energy-efficient domestic wastewater treatment, but the effluent quality has typically not been sufficient for discharge without further treatment. A two-stage laboratory-scale combined treatment process, consisting of microbial fuel cells and an anaerobic fluidized bed membrane bioreactor (MFC-AFMBR), was examined here to produce high quality effluent with minimal energy demands. The combined system was operated continuously for 50 days at room temperature (similar to 25 degrees C) with domestic wastewater having a total chemical oxygen demand (tCOD) of 210 +/- 11 mg/L. At a combined hydraulic retention time (HRT) for both processes of 9 h, the effluent tCOD was reduced to 16 +/- 3 mg/L (92.5% removal), and there was nearly complete removal of total suspended solids (TSS; from 45 +/- 10 mg/L to <1 mg/L). The AFMBR was operated at a constant high permeate flux of 16 L/m(2)/h over 50 days, without the need or use of any membrane cleaning or backwashing. Total electrical energy required for the operation of the MFC-AFMBR system was 0.0186 kWh/m(3), which was slightly less than the electrical energy produced by the MFCs (0.0197 kWh/m(3)). The energy in the methane produced in the AFMBR was comparatively negligible (0.005 kWh/m(3)). These results show that a combined MFC-AFMBR system could be used to effectively treat domestic primary effluent at ambient temperatures, producing high effluent quality with low energy requirements.