This study proposed an efficient way of direct sewage pre-concentration by a combined coagulation microfiltration (CCM) system and an optimal operational strategy of aeration. Compared to two typical technologies for sewage pre-concentration, i.e. direct sewage microfiltration (DSM) and continuous aerated sewage microfiltration (ASM), the CCM system under optimal aeration strategy showed higher concentration efficiency and slower permeability decline (i.e. better control of membrane fouling), and easier collection of retained organic matter (OM). A lab-scale CCM reactor was running continuously for 295 h, and a concentrate of about 16,000 mg COD/L was produced at an average net flux of 13.3 L/(m2 h) and an influent OM recovery of nearly 70%, which was higher than the concentrate produced by a high-loaded membrane bioreactor (MBR) with one day solids retention time. The use of chemical coagulant was found to have little impact on the following anaerobic digestion (AD) process, for anaerobic biodegradability of the concentrate is 56.5% (close to the typical value for blackwater). The integration of the CCM and AD processes could achieve a net energy production of 0.0098 kW h/m3 after deduction of 0.0919 kW h/m3 required for the operation of the CCM system, thus showing promise as an effective OM concentration method for energy recovery from sewage.