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Limited water resources and ensuring access to clean water are critical environmental challenges, especially for the developing world. In particular, rural domestic wastewater has become a significant source for the pollution of freshwater bodies. A modified bio-ecological A2O-wetland system for rural wastewater treatment consisting of a biological unit (anaerobic baffled reactor, anoxic tank and oxic unit, A2O) and an ecological unit (horizontal flow constructed wetland) was developed, and key performance indicators were identified. The bio-ecological treatment system showed high removal efficiency for pollutants, successfully achieving 91%, 85%, 78%, and 92% removal efficiencies for chemical oxygen demand (COD), ammonium (NH4–N), total nitrogen (TN), and total phosphorus (TP), respectively. The concentrations of pollutants in the effluent from the system were lower than the Class 1 A regulated values of the Chinese National Standard GB18918-2002. The system offered high removal efficiency, simple operation, and low energy consumption. The A2O-wetland is a good alternative for rural wastewater treatment systems.