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This article evaluates the performance of 10 large scale upflow anaerobic sludge blanket (UASB) sewage treatment plants (STP) located in semi-tropical areas, 7 plants were located in Brazil, 2 in India and 1 in the Middle East. In addition to the UASB, essential functional units of the STP which potentially impact on the UASB are also evaluated. Most grit removal systems were performing adequately, however in one plant very little grit was being removed. This could have serious implications for the performance of the plant as in a relatively short period of time the reactors could become full of grit. The performance results obtained in this study (COD, BOD and TSS removal efficiencies) are compared to the results of recent literature publications and also to the results of some early pilot and full scale studies. The results found here are broadly similar to those result reported in the recent literature but show a lower performance in comparison with the early pilot scale plants. Factors such as improper design, poor operating procedures, insufficient maintenance and the presence of high sulphate concentrations have been identified as the main reasons for the lower performance.