Abstract: The palm oil industry is a vital economic backbone of Malaysia since it is one of the world’s largest producer and exporter of palm oil despite creating enormous environmental problems, one being the huge generation of Palm Oil Mill Effluent (POME) during the oil extraction process. This highly polluting wastewater contains high concentrations of Biological Oxygen Demand (BOD) and Chemical Oxygen Demand (COD). Due to the high organic content of POME, biological treatment method seems to be a preferable solution. Therefore, a series of treatment comprising of fermentation, algae, biofilm and membrane system is proposed as one of the possible option to treat POME. This paper also reviews few configurations and modes of operation of several biofilm treatment systems as well as focusing on the application of a Fluidized Bed Biofilm Reactor (FBBR) in treating POME further down the proposed treatment chain.