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• Non-fixed bed ion exchange for NOM removal is reviewed for the North Sea region. • Ion exchange treatment removed 40 to 60% of NOM, mainly humic fractions. • Ion exchange lowered the coagulant dosage and the UV/advanced oxidation energy use. • Ion exchange had low influence on fouling limitation of microfiltration membranes. • Ion exchange lowered the formation of disinfection by-products. Natural organic matter (NOM) fractions cause problems in drinking water treatment and supply. In the North Sea region, anionic ion exchange (IEX) in non-fixed bed configurations has been considered for NOM removal in drinking water treatment plants. This paper discusses several experiences of the impact of anion IEX on NOM removal and on NOM-related problems in water treatment locations of the North Sea region, considering the specific situation of the sites. The investigated parameters include the effect of anionic IEX on the removal of total NOM and specific NOM fractions, the amount of chemicals used for coagulation, the development of trans membrane pressure in microfiltration, the formation of assimilable organic carbon and the energy consumption during advanced oxidation, the removal of organics by activated carbon, and the formation of disinfection by-products. The pilot experiences at three treatment locations in Belgium, United Kingdom and the Netherlands show that anionic IEX (1) removed typically 40 to 60 percent of total NOM; (2) targeted mostly humic NOM fractions, and was not effective to remove biopolymers (3) contributed to lower coagulant doses and energy consumption in UV/advanced oxidation; (4) had limited influence on limiting the fouling of microfiltration membranes; (5) lowered the formation of disinfection by-products; and (6) it can improve biological stability. [ABSTRACT FROM AUTHOR]