Abstract: A sewage removal system for low water use toilets within an insulated building, the system comprising a transfer tank to collect sewage by gravity from the toilet, a holding tank remote from the transfer tank, a sewage discharge pipe extending between the transfer tank and the holding tank for fluid communication between the transfer tank and the holding tank, the sewage discharge pipe rising to a point, along its length, which is significantly above the fluid level in each of the transfer tank and the holding tank, a vent pipe for the interior of the holding tank and blower associated with the vent pipe, when activated to create a sufficient vacuum within the holding tank to draw sewage from the transfer tank, through the discharge pipe, into the holding tank, and a switch associated with the transfer tank and arranged so as to activate the blower, when the level of the sewage in the transfer tank rises to a predetermined height and to deactivate the blower when that level falls to a predetermined height.