Nowadays, carbon emission and therefore carbon footprint of water utilities is an important issue. In this respect, we should consider the opportunities to reduce carbon footprint for small and large wastewater treatment plants. The use of anaerobic rather than aerobic treatment processes would achieve this aim because no aeration is required and the generation of methane can be used within the plant. High-rate anaerobic digesters receive great interests due to their high loading capacity and low sludge production. Among them, the upflow anaerobic sludge blanket (UASB) reactors have been most widely used. However, there are still unresolved issues inhibiting the widespread of this technology in developing countries or countries with climate temperature fluctuations (such as subtropical regions). A large number of studies have been carried out in order to enhance the performance of UASB reactors but there is a lack of updated documentation. In face of the existing limitations and the increasing importance of this technology, the authors present an up-to-date review on the performance enhancements of UASB reactors over the last decade. The important aspects of this article are: (i) enhancing the start-up and granulation in UASB reactors, (ii) coupling with post-treatment unit to overcome the temperature constraint, and (iii) improving the removal efficiencies of the organic matter, nutrients and pathogens in the final effluent. Finally the authors have highlighted future research direction based on their critical analysis. Display omitted ► We review various enhancements made on the anaerobic digestion of domestic sludge. ► The aspects considered are granulation or start-up of UASB reactors, climate temperature constraints and effluent quality. ► We provide a database and perspectives for future improvement.