This paper outlines design considerations for constructed wetlands with horizontal subsurface flow treating domestic wastewater in cold climates of northern latitudes. Particular attention is devoted to the use of a filter medium with high phosphorus adsorption capacity. Experience from two Norwegian multistage systems consisting of an aerobic pretreatment step followed by constructed wetland units indicates purification processes are nearly the same during winter and summer seasons, with quite high removal of organic matter (COD, BOD), phosphorus and nitrogen.