Membrane bioreactors (MBRs) are an attractive technology for drinking water applications because they provide the advantages of biological treatment and simultaneously mitigate the risk of microorganism passage into the product water. However, current MBR configurations result in inherent antagonisms between the membrane performance and the biological process efficiency. This paper introduces a novel hybrid sorption-membrane-bioreactor configuration that resolves these antagonisms and provides additional synergies between process components. This process configuration consists of an upflow bed of biologically active granular adsorption media situated directly below or adjacent to a microfiltration (MF) or ultrafiltration (UF) membrane and is abbreviated as MBR-UFGA (UpFlow Granular Adsorbent). In this study, a submerged-style UF membrane module was preceded by a biologically active upflow bed of granular pyrolusite (MnO2) adsorption media used for concurrent biological removal of ammonia and physicochemical removal of iron and manganese. The MBR-UFGA configuration was compared to a more traditional MBR process configuration, where the nitrifying biomass was instead located in the immediate vicinity of the membrane for ammonia removal while physicochemical removal of metals was achieved with the addition of a powdered activated MnO2 adsorbent and aeration. This second process configuration is abbreviated MBR-PA (Powdered Adsorbent) and provided a baseline for comparison of the proposed novel process. The MBR-UFGA process configuration resulted in superior membrane hydraulic performance as it extended the chemical cleaning intervals by over 250% when operated under the same flux and other operating conditions. Additional experiments performed without biomass addition indicated that the biomass or biologically derived compounds were responsible for the majority of the accelerated fouling in the more traditional MBR-PA configuration. The novel MBR-UFGA process also resulted in a more stable and higher level of removal for ammonia and manganese. With the MBR-PA process, steadily decreasing biological ammonia removals resulted from mass transfer limitations that developed as the biomass migrated from suspension to the surface of the membrane over the course of the experimental runs. Removal of manganese in the MBR-PA process was initially poor, but increased over time as the concentration of the powdered adsorbent accumulated in the reactor. This research focused on a specific drinking water application, but the findings have equally important implications for water reuse and wastewater MBR applications. Includes 8 references, tables, figures.