To achieve optimal performance, anaerobic digestion (AD) requires well-balanced operation conditions, steady physical–chemical conditions, and adequate nutrient concentrations. The use of anaerobic structured-bed reactor (ASTBR) presents these conditions. However, several additional investigations are required to elucidate robustness to treat domestic sewage (DS). This pioneering study investigated the performance of an ASTBR in treating DS across four decreasing hydraulic retention times (HRTs) (12, 8, 6, and 5 h). The study aimed to assess organic matter removal, the influence on physical–chemical parameters, and the monitoring of trace metals (TMs) during long-term operation (614 days). Overall, the results underscore the viability of employing ASTBR for DS treatment, achieving an average chemical oxygen demand (COD) removal efficiency of 70%. The system demonstrated consistent long-term operation over 614 days, maintaining stability even with decreasing hydraulic retention times (HRTs). The average effluent concentration of volatile fatty acids (VFAs) was 20.4 ± 3.3 mg L−1, with a pH value averaging 7.2 ± 0.1. TM concentrations at an HRT of 12 h exhibited higher levels in the effluent compared to the influent, gradually decreasing over the course of operation and ultimately stabilizing at levels similar to those observed in the influent. The concentrations of metals, including Ba, Cr, Fe, Mn, Ni, Pb, Se, and Zn, monitored in the effluent samples adhered to the allowable discharge thresholds as stipulated by Brazilian regulations.