A tertiary wastewater treatment pilot plant using a simplified UASB reactor followed by a SSF was operated on effluent wastewater from a house in an unsewered village in Egypt. The UASB reactor followed by a final sedimentation tank was operated at a constant hydraulic retention time of 12 hours while the SSF was operated at the different ROF 3, 4, and 5 m3/m2/day. A woven cotton textile media was placed above the sand layer to increase the filter efficiency and ease filter cleaning after the formation of the dirty skin. The overall system efficiency for the parameters tested was high and the values recorded for run 1 with a ROF of 3 m3/m2/day compared with the other rates were slightly higher. The main noticeable drawback was in the SSF operation period before clogging which varied drastically from 52 to 38 to 29 days for each run respectively. The highest removal efficiencies recorded were 99.67±0.04%, 98.51±0.44% and 98.06±0.43% for TSS, BOD5 and COD respectively. While the removal rates of the nutrients monitored were 90.19±6.18%, 87.25±5.73% and 86.32±10.15% for NH4-N, TN and TP respectively. Two bacteriological parameters were also monitored and their removal efficiencies were significantly high due to the biological dirty skin layer formed on the SSF and the removal values were 99.86±0.04% and 98.20±0.82% for Escherichia coli and fecal coliform respectively. Overall system evaluation can be rated as very low O&M requirements for both skilled manpower and energy requirements.