A conventional activated sludge (CAS) system has traditionally been used for secondary treatment in wastewater treatment plants. Due to the high cost of aeration and the problem of sludge treatment, researchers are developing alternatives to the CAS system. A membrane bioreactor (MBR) is a technology with higher solid-liquid separation efficiency. However, the use of MBR is limited due to inevitable membrane fouling and high energy consumption. Membrane fouling requires frequent cleaning, and MBR components must be replaced, which reduces membrane lifetime and operating costs. To overcome the limitations of the MBR system, a microbial fuel cell-membrane bioreactor (MFC-MBR) coupling system has attracted the interest of researchers. The design of the novel bioelectrochemical membrane reactor (BEMR) can effectively couple microbial degradation in the microbial electrochemical system (MES) and generate a microelectric field to reduce and alleviate membrane fouling in the MBR system. In addition, the coupling system combining an MES and an MBR can improve the efficiency of COD and ammonium removal while generating electricity to balance the energy consumption of the system. However, several obstacles must be overcome before the MFC-MBR coupling system can be commercialised. The aim of this study is to provide critical studies of the MBR, MES and MFC-MBR coupling system for wastewater treatment. This paper begins with a critical discussion of the unresolved MBR fouling problem. There are detailed past and current studies of the MES-MBR coupling system with comparison of performances of the system. Finally, the challenges faced in developing the coupling system on a large scale were discussed.