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The application of enhanced biological phosphorus removal (EBPR) in wastewater treatment plants (WWTPs) has commonly been utilized worldwide. However, the optimum efficiency has not been realized over the past decades, prompting many studies and publications. The limitations, especially comprehension of the abundance and actual potential of polyphosphate-accumulating organisms (PAOs), are not fully understood. Recently identified putative PAOs, <i>Tetrasphaera</i>, present a vast metabolic versatility compared to <i>Candidatus</i> Accumulibacter. The characterisation of <i>Tetrasphaera</i> unique abilities to utilize various carbon substrates, volatile fatty acids production and consistent high abundance, presents potential boosts towards the process efficiency improvement. This paper provides the existing knowledge on the physiology, morphology and genetic description of PAOs with a special attention to the current state of research on <i>Tetrasphaera</i> and its potential. In addition, process conditions and their influence on the microbial activities in EBPR systems are discussed.