Need of self-sustaining wastewater treatment plants (WWTPs) has become critical to cope up with dynamics of the environmental regulations and rapid advancements in the contemporary technologies. At present there are limited number of self-sustaining WWTPs around the world. The aim of this chapter is to present state -of- art of Downflow Hanging Sponge (DHS) system which was developed as a post treatment unit of Upflow Anaerobic Sludge Blanket (UASB) from sustainability perspective. DHS system is a non-submerged fixed bed trickling filter (TF) that employs a core technology of polyurethane sponges as a media where the microorganisms thrive and major treatment processes take place. This chapter reviews the introduction of DHS system (UASB+DHS) summarizes the quantitative analysis of environmental, economic and social sustainability using indicators. Furthermore, self-sustaining prospects of DHS system are assessed and discussed by comparing with conventional TF (UASB+TF).