Climate-related issues constitute an important obstacle for the development of treatment wetland (TW) applications in regions with freezing winter temperatures. The aim of the present study was to evaluate the efficiency of a new configuration of TWs based on the vertical flow (VF) configuration. The proposed TWs system is planted with a willow species (Salix miyabeana SX67) and including design adaptations for cold climate operation. Two different flow modes for winter-time operation were proposed: percolated and saturated with continuous artificial aeration. The pilot-scale systems were tested with municipal wastewater, at an organic loading ranging from 5 to 20 g CBOD5 m−2 d−1. The pilot TWs were successfully operated for 22 months despite freezing winter temperatures reaching as low as −32 °C. Willow development was normal, with evapotranspiration ranging from 19 to 23 mm/d in July 2017 for the pilot TWs at an organic loading of 10 g CBOD5 m−2 d−1. Organic matter removal efficiency was high for all pilot TWs, with an average 91% COD and 81% TSS removal. Nitrification was essentially complete during the summer period and remained high for pilot TWs operated under percolating flow mode in winter but was lower for the saturated flow mode, probably due to insufficient air supply. Our study confirms the successful application of a modified version of VF TW in regions with freezing air temperatures.