Tourists visiting mountain refuges in the Alps have increased significantly in the last decade and the number of refuges and huts at high altitude too. In this research the results of an intensive monitoring of a wastewater treatment plant (WWTP) for a tourist mountain refuge located at 2,981 m a.s.l. are described. Two biofilm reactors were adopted: (a) a Moving Bed Biofilm Reactor (MBBR); (b) a submerged Fixed Bed Biofilm Reactor (FBBR). The aims of this research were: (i) the evaluation of the main parameters characterising the processes and involved in the design of the wastewater plants, in order to compare advantages and disadvantages of the two tested alternatives; (ii) the acquisition of an adequate knowledge of the problems connected with the wastewater treatment in alpine refuges. The main results have been: (i) a quick start-up of the biological reactors obtainable thanks to a pre-colonization before the transportation of the plastic carriers to the refuge at the beginning of the tourist season; (ii) low volume and area requirement; (iii) significantly higher removal efficiency compared to other fixed biomass systems, such as trickling filters, but the energy consumption is higher.