The incineration of municipal solid waste has been important in waste management, but it raises another environmental issue concerning residue treatment. This study describes an innovative use of naturally aged incineration bottom ash (AIBA) as an alternative substrate for horizontal subsurface flow (HSSF) constructed wetlands (CW). Although experimental results from a period lasting for 396 days only revealed slightly higher removal ratios in HSSF with AIBA (HSSF-E) than in HSSF-traditional pebble beds (HSSF-C), increasing from 67% to 76% for BOD, 44%-51% for TKN, 47%-54% for NH3-N, and 44%-52% for TN. The data indicate that the use of AIBA in HSSF CW can achieves a certain removal efficiency of BOD and nitrogen species. Interestingly, the total phosphorus removal rates also increased significantly from 20% in HSSF-C to 36% in HSSF-E. These observations on the use of AIBA in HSSF CW confirmed that AIBA is a suitable alternative for use as a substrate for HSSF CWs and identified an additional way to reuse incineration bottom ash. Design criteria for a CW using AIBA as a partial substrate is proposed to improve the pollutant removal performance of HSSF CWs.