A sustained eight-year major research effort has been undertaken in South Africa to develop integrated passive water treatment systems for the sustainable removal of sulfates, while simultaneously addressing the removal of metals and acidity. The research effort addressed the problem both at a fundamental science level and at the more empirical pilot plant level. Whereas there are numerous anaerobic sulfate reducing reactors in operation on mine waters that remove some sulfate together with metals and acidity, these are typically plagued by low sulfate removal efficiency and gradual reductions in overall reactor efficiency with time. The South African research effort has focused on understanding the fundamental microbiological and biochemical reactions that occur in anaerobic reactors filled with lignocellulosic material and subjected to high sulfate water. Hypotheses have been developed that differentiate the reactions occurring in such a reactor into groups that should be individually optimised and these hypotheses have been verified through rigorous laboratory and pilot scale studies. The results of this research are incorporated into a patented multi-stage integrated passive treatment system that is capable of sustained high rate removal of sulfates, metals and acidity.