The anaerobic ammonium oxidation (anammox) process is a promising wastewater treatment method for biological nitrogen removal. A sufficient amount of active anammox sludge as a seed is crucial to the fast establishment and stability of the anammox process. Anammox bacteria is a kind of microorganism which is sensitive to the environmental conditions, e.g., oxygen, temperature. The optimum temperature and pH for the growth of the anammox bacteria are 30-40 A degrees C and 6.7-8.3. A proper preservation technique allows fast start-up of the anammox process, overcoming the long doubling time of anammox biomass. The preservation of the anammox sludge is influenced by various factors, e.g., preservation techniques, duration, temperature, substrates, and protective agents. During preservation, the characteristics of the anammox biomass, including the bioactivity, heme c content, extracellular polymeric substances (EPS), and sludge morphology, change with time. The optimum preservation technique is not invariable and it depends on the purpose of preservation (precedence of bioactivity or quantity), the bacterial community, and other parameters. It is important for the preserved anammox biomass to achieve reactivation so that stable anammox reactors can be established as soon as possible. However, because the preservation process is complicated, the knowledge regarding preservation is far from complete, and much future work will be required to increase the understanding of preservation.