Alkaline and ultrasonic sludge disintegration can both be used as pretreatments of waste activated sludge (WAS) for improving the subsequent anaerobic or aerobic digestion. The pretreatment has been carried out using different combination of these two methods in this study. The effect was evaluated based on the quantity of soluble chemical oxygen demand (SCOD) in the pretreated sludge as well as the degradation of organic matter in the following aerobic digestion. For WAS samples with combined pretreatment, the released COD was in high level than those with ultrasonic or alkaline treatment. When combined with the same ultrasonic treatment, NaOH treatment resulted in more solubilization of WAS than Ca(OH)2. For combined NaOH and ultrasonic treatments with different sequences, the released COD were in the order: simultaneous treatment > ultrasonic treatment following NaOH treatment > NaOH treatment following ultrasonic treatment. For simultaneous treatment, low NaOH dosage (100 g/kg dry solid), short duration (30 min) of NaOH treatment, and low ultrasonic specific energy (7 500 kJ/kg dry solid) were beneficial for sludge disintegration. Using combined NaOH and ultrasonic pretreatment with the optimium parameters, the degradation efficiency of organic matter was increased from 38.0% to 50.7%, which is much higher than with ultrasonic (42.5%) or with NaOH pretreatment (43.5%) in the subsequent aerobic digestion at the same retention time.