The performance of a single sludge integrated attached growth system comprising of an aerobic and anoxic tanks in biological nutrient removal was evaluated in treating synthetic wastewater simulating medium strength domestic wastewater. An aero-packer and bio-balls were installed in the aeration and anoxic tank occupying about 40 and 25 of both tanks respectively. The efficiency of the integrated attached growth system was evaluated on the removal of chemical oxygen demand (COD), ammonia removal (NH3), nitrate removal (NO3), total suspended solids removal (TSS) and biochemical oxygen demand removal (BOD5). Effluent results show that the integrated attached growth system had a removal efficiency of 97.8 (COD), 97.5 (NH3), 87.5 (NO3), 97 (TSS) and 97.1 (BOD). These results support the viability of an integrated system in mitigating the enormous challenges of a conventional wastewater treatment. © (2014) Trans Tech Publications, Switzerland.