A lab-scale anaerobic baffled biofilm reactor (ABBR) was used as a novel reactor to start up Anammox process at a moderate temperature around 20 degrees C and an innovative filling module was adopted as support material. Quick start-up of Anammox process from the aerobic activated sludge was achieved after 47 days operation. The max nitrogen loading rate and nitrogen removing rate attained 1.00 kg N m(-3) d(-1) and 0.90 kg N m(-3) d(-1) after 161 days operation. Scanning electron microscope photographs showed that the structure as well as the states of the micro-aggregates (micro-aggregates sticking on a non-woven fiber, entangling non-woven fibers and enwrapped by non-woven fibers) enhanced biomass retention for Anammox bacteria. Microbial community analysis showed that Anammox bacteria were effectively enriched with Candidatus Brocadia, Candidatus Jettenia and Candidatus Kuenenia being the main Anammox species in the mature biofilms. This contributed to the excellent Anammox operation performance at the moderate temperature.