This article summarizes the results obtained during the laboratory and pilot development of integrated biologic and physicochemical treatment and reuse of diluted pig manure streams. The application of a straw filter was an effective means to separate the solid and liquid fractions of raw wastewater and resulted in the removal of a significant part of the dry matter, total nitrogen, and phosphorus (65, 27, and 32%, respectively). From the filtrate generated, 60–80% of the total chemical oxygen demand (COD) was removed in an upflow anaerobic sludge bed reactor operating at 15–30°C. Ammonia was efficiently eliminated (>99%) from the anaerobic effluents using Ural laumantite as an ion exchanger. However, the nitrogen-content of the zeolite was too low to consider this method of ammonia removal economically feasible. The phosphate precipitation block, consisting of stripper of CO2 and fluidized-bed crystallizator, was able to decrease the concentration of soluble phosphate in the anaerobic effluents up to 7–15 mg of phosphate/L. The application of aerobic/anoxic biofilter as a sole polishing step was acceptable from an aesthetic point of view (the effluents were transparent and almost colorless and odorless) and elimination of biochemical oxygen demand (the resting COD was hardly biodegradable). However, the effluent nutrient concentrations (especially nitrogen) were far from the current standards for direct discharge of treated wastewater. We discuss the approaches for further improvement of effluent quality. Finally, we provide an outline of a full-scale system that partially implements the laboratory- and pilot-scale results obtained.