Submerged membrane adsorption bioreactor (SMABR) was investigated as a pretreatment to reverse osmosis (RO). SMABR removed organic matter by adsorption and biological degradation. At a powder activated carbon (PAC) residence time of 66 d (1.5% of PAC replacement daily), higher organic removal was achieved with removal of a majority of biopolymers (9497%) and humics (7176%). A continuous MBR operation with the optimal PAC residence time of 66 d was conducted and compared with MBR with no PAC replenishment in terms of the removal of organic and microbes. High removal of organics of up to 72% was maintained with only a marginal increment of trans-membrane pressure and stable bioactivity (total cell number and adenosine tri-phosphate) during the 50 d of operation. The SMABR was found to be a sustainable biological pretreatment to RO with only a small amount of PAC requirement (2.14 g of PAC/m3 of seawater treated).