A detailed comparison of sand filtration (SF) and ultrafiltration (UF) was conducted in this study with the aim to provide systematic support for alternative UF and SF technologies. The results of natural organic matter (NOM) removal indicated that SF conferred a slightly higher removal rate for UV-absorbing compounds, humic-like substances and protein-like substances than UF, with removal efficiencies of 21.9%, 19.8% and 26.1%, respectively. In addition, SF and UF exhibited different removal performances for organic fractions: UF better removed high molecular-weight (MW) organics, while SF exhibited higher removal of medium-MW organics. Furthermore, chlorine and chlorine dioxide were used as disinfectants to compare the different influences of SF and UF on disinfection by-product (DBP) formation. Unexpectedly, SF exhibited a better capacity for reducing the formation of chlorite than the UF process, with concentrations of 0.57 mg/L and 0.69 mg/L, respectively. Importantly, for the emergency scenario, e.g. seasonal algae pollution, the UF process achieved significantly higher removal of algae cells (98.7%) than SF due to size exclusion, indicating substantial resistance to algae load shocks. Therefore, these findings are beneficial for making practical decisions to adopt SF or UF technology in drinking water treatment plants.