Anaerobic membrane bioreactors (AnMBRs) are a recent development in wastewater treatment driven by concerns about energy use and sludge disposal. It separates hydraulic retention time from solid retention time enabling short retention times (as low as 3–6 h, but normally 12–24 h), and excellent performance (85–95% chemical oxygen demand (COD) removal, no effluent solids and high bacterial/virus removal). It produces low-sludge yields (0.04–0.12 g sludge/g CODrem), and methane in both the gas and dissolved in the effluent (lower temperatures yield higher soluble methane). It can be net energy positive depending on its configuration, for example, using ‘dynamic membranes’, mechanically shaken membrane or a two-stage granular activated carbon (GAC) bed reactor. However, membranes ranging from ultrafiltration (0.04 μm) to microfiltration (0.4 μm) foul quite quickly, with Soluble Microbial Products (SMPs)/Extra Cellular Polymers (ECPs-which include extracellular polysaccharides) and cells depositing and growing on the surface. At a certain cell density Quorum Sensing (QS) occurs and there is a rapid increase in trans-membrane pressure (‘TMP jump’). Fouling can be ameliorated by managed gas sparging, mechanical shaking, addition of flocculants/adsorbents, for example, powdered activated carbon, or quorum quenching. Nevertheless, some fouling is important as it enhances membrane performance. Due to the membrane rejecting cells and many low molecular weight solutes, AnMBRs tolerate shock loads and toxins well, and enable microbial adaptation to occur. However, to improve performance more research is needed to minimize overall energy use, explore enhanced performance with bioaugmentation, enhance rates of solid hydrolysis, optimize its performance in the overall flowsheet (global optimization), use life-cycle analysis to reduce its environmental impact, control sulphate reduction and improve post-treatment of effluents to enable water recycling.