This research evaluated combined ion exchange (CIX) as a pre-treatment and post-treatment for high pressure membrane systems. CIX uses anion and cation exchange resins to remove dissolved organic matter (DOM) and calcium from water and concentrate streams. Laboratory experiments showed CIX pre-treatment reduced fouling of membranes exposed to humic acid solutions, allowing higher recovery, but had minimal effect on fouling from solutions with Suwannee River natural organic matter. Further research is needed to understand how organic matter characteristics influence CIX effectiveness and fouling.