In order to simultaneously remove carbon and nitrogen from organic-rich wastewater, we used an up-flow anaerobic sludge bed/blanket (UASB) reactor that was started up with anammox with high concentration of carbon and nitrogen by gradually raising the organic loading of influent. We optimized the removal of nitrogen and carbon when the chemical oxygen demand (COD) concentration varied from 172 to 620 mg/L. During the entire experiment, the ammonium and total nitrogen removal efficiency was higher than 85%, while the average COD removal efficiency was 56.6%. The high concentration of organic matter did not restrain the activity of anammox bacteria. Based on polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and tapping sequencing analyses, the Planctomycete, Proteobacteria, Chloroflexi, Chlorobi bacteria are detected in the UASB reactor, which indicated complex removal pathway of carbon and nitrogen coexisted in the reactor. However, a part of Planctomycete which referred to anammox bacteria could tolerate a high content of organic carbon, and it provided help for high performance of nitrogen removal in UASB reactor.