The capability of Scenedesmus obliquus to remove cations (K+, Na+, Ca2+, Mg2+) from saline-alkaline water was investigated at different salinities (0, 5, 10, 15, 20, 25) and carbonate alkalinities (0, 5, 10, 15, 20, 25, 30, 35 mmol/L). K+, Na+, Ca2+, and Mg2+ in saline-alkaline water were efficiently removed by S. obliquus. The maximum removal of the cations (29.37 mg for K+, 185.85 mg for Na+, 23.07 mg for Ca2+, 66.14 mg for Mg2+) occurred at salinity 25. The maximum removal of K+ (2.28 mg), Na+ (6.62 mg), Ca2+ (1.01 mg), and Mg2+ (0.62 mg) occurred at carbonate alkalinities of 25 mmol/L for K+, 35 mmol/L for Na+, 20 mmol/L for Ca2+, and 25 mmol/L for Mg2+, respectively. Under a salinity stress, the concentration of Na+ in S. obliquus increased significantly, while that of K+ decreased significantly. The concentrations of Ca2+ and Mg2+ decreased as well. The ratios of K+/Na+, Ca2+/Na+, and Mg2+/Na+ were significantly lower in all salinity treatments than those of the control. Under alkaline stress, the concentrations of Na+ and K+ in S. obliquus decreased significantly and the ratios of K+/Na+, Ca2+/Na+, and Mg2+/Na+ were significantly higher in all treatments than in the control. Moreover, the concentrations of Ca2+ and Mg2+ in S. obliquus at alkalinities of 5–10 mmol/L were significantly higher than those of the other treatments. The removal of Na+ by S. obliquus mainly occurs through biosorption, and Mg2+ and Ca2+ were removed through both biosorption and bioaccumulation.