Nitrate/nitrite-dependent anaerobic methane oxidation (Nx-damo) is a newly demonstrated microbiological pathway for C and N cycle. This finding is significant for not only the understanding of the mechanisms of microorganisms driven cycling of biogenic elements, but also the development of sustainable wastewater treatment technology focusing on nitrogen removal and mitigation of green-house gas release. In this paper, the current advances in Nx-damo, including the identification and natural distribution of responsible microorganisms, their enrichment and the effect factors, as well as the physiological property and metabolic pathways, were reviewed. Advantages and potentials of Nx-damo based wastewater treatment technology were evaluated. Finally, perspectives on expected research and development of Nx-damo were suggested from microbiological and engineering aspects. Purpose of this review is to provide valuable information to promote more research on this field.