A novel treatment process combining a membrane with outside-in flow configuration and a fluidized pellet rector for removing hardness was studied. The effects of influent water quality, e.g., concentrations of natural organic matter (NOM) and phosphate along with the hydrophobicity of NOM, on the hardness removal efficiency of the novel process were investigated. The hardness removal efficiency decreases with increasing NOM concentration. However, the NOM removal efficiency is independent of NOM concentration and is related to the hydrophobicity of NOM samples. Raw water containing phosphate has adverse impact on the hardness removal efficiency, which decreases from 85% for treating water containing no phosphate to only 38% and 14% for water containing 0.33 mg/L and 1.63 mg/L of phosphate, respectively.