Effective treatment of wastewater is crucial in order to achieve a sustainable development. For instance, highly efficient treatment processes with low capital requirements are the major prerequisite for implementation of the advanced wastewater treatment operations. Among various available treatment methods, the application of coagulation-flocculation process by using natural coagulant; chitosan has vast advantages such as low operating cost, environmental friendly and highly effective in the wastewater treatment operations. The application of nanotechnology in numerous treatment techniques are considered as the most significant advances in water and wastewater treatment practices. The utilization of magnesium oxide (MgO) as nano-adsorbent has recently gained attention as a potential treatment method in water remediation particularly for treating effluents with high amount of organic dyes and heavy metals due to its high treatment efficiency, low cost, versatility and environment compatibility. The purpose of this study was to determine the effectiveness of coagulation-flocculation process when using novel coagulant in which MgO coated with chitosan by investigating the percentage removal of several significant parameters which were turbidity, chemical oxygen demand (COD) and suspended solid. The removal efficiencies were determined throughout a series of experiments carried out using a standard jar test procedure in which three different coagulants; chitosan, MgO coated with chitosan and MgO were tested on water samples taken from Sg. Pusu. In addition, a set of experiments was designed using response surface methodology (RSM) in order to optimize adsorption of chitosan into MgO. The experiments were conducted at various concentrations of chitosan (10-30 mg/ml) and selected MgO dosage ranges (10-30 mg). From the obtained results, it was found that chitosan-MgO coagulant has good removal efficiencies of turbidity, chemical oxygen demand (COD) and suspended solids at 92%, 91%, and 98% respectively from the optimization of adsorption of chitosan-MgO. The MgO coated with chitosan is the best coagulant in this study compared to chitosan and MgO alone because of the ability of treating the river water with up to 90 % removal for all the main parameters. The results showed that coagulation-flocculation is effective as a treatment for treating river water.