This study investigated microbial communities and their diversity in a full-scale mesophilic anaerobic digester treating sewage sludge. Influent sewage sludge and anaerobic digester samples collected from a wastewater treatment plant in Busan were analyzed using high-throughput sequencing. It was found that the microbial community structure and diversity in the anaerobic digester could be affected by inoculation effect with influent sewage sludge. Nevertheless, distinct microbial communities were identified as the dominant microbial communities in the anaerobic digester. Twelve genera were identified as abundant bacterial communities, which included several groups of syntrophic bacteria communities, such as Candidatus Cloacimonas, Cloacimonadaceae W5, Smithella, which are (potential) syntrophic-propionate-oxidizing bacteria and Mesotoga and Thermovigra, which are (potential) syntrophic-acetate-oxidizing bacteria. Lentimicrobium, the most abundant genus in the anaerobic digester, may contribute to the decomposition of carbohydrates and the production of volatile fatty acids during the anaerobic digestion of sewage sludge. Of the methanogens identified, Methanollinea, Candidatus Methanofastidiosum, Methanospirillum, and Methanoculleus were the dominant hydrogenotrophic methanogens, and Methanosaeta was the dominant aceticlastic methanogens. The findings may be used as a reference for developing microbial indicators to evaluate the process stability and process efficiency of the anaerobic digestion of sewage sludge.