The anaerobic ammonium oxidation (anammox) process is an autotrophic nitrogen removal process with great potential as a cost-effective and highly efficient technology in the wastewater treatment field. The main challenges yet to be overcome in this new frontier technology are operating at lower temperatures and achieving a high and stable nitrogen removal efficiency. In this study, an up-flow expanded bed reactor with hydroxyapatite (HAP)-anammox granules was operated for more than 200 days at 7°C. The nitrogen loading rate (NLR) was improved from 1.0 g-N/L/d to 3.6 g-N/L/d, together with a high-level nitrogen removal efficiency of 84-92%, which is the highest to date at extremely low temperatures in a continuous experiment. Candidatus Kuenenia was revealed to be the only dominant anammox genus, with a relative abundance of 35.3-37.5%. The optimal operational temperature was around 35°C and the apparent activation energy (Ea) was calculated as 78.37 kJ/mol. The three-layers architecture and architectural evolution of HAP-anammox granules into HAP-cores and peeling biofilms with outstanding settling performance were characterized. Under 7°C, the high capacity of nitrogen removal with robust removal efficiency using HAP-anammox granules was achieved.