Pressurization pretreatment is reported as a novel pretreatment method for the coagulation removal of Micro-cystis sp. from eutrophicated water, as less coagulant is required than without pressurization. However, how cellular properties and algogenic organic matter (AOM) characteristics change with pressurization pretreatment and thus reduce the coagulant dose are still not understood. Using Microcystis flos-aquae in Lake Taihu, this study analyzed the changes in cellular morphology, size distribution, and charge density, as well as the changes in concentration and composition of cell-based protonated functional groups. Coagulation experiments using different combinations of cells and AOM with/without pressurization pretreatment showed that the changes in cell surface properties played a bigger role in coagulation enhancement than AOM. The enhancement of the coagulation efficiency of M. flos-aquae with pressurization pretreatment is related to the rupture of the muci-laginous sheath and subsequent exposure of cells with more active functional groups, the content of phospho-diester, carboxyl and phosphoryl functional groups on the surface of M. flos-aquae cells increased by 55%, 29% and 203%, respectively. Thus increasing the binding sites between M. flos-aquae cells and cationic poly-acrylamide (CPAM). As a result, with pressurization pretreatment, the dose of CPAM was reduced from 5 mg L-1 to 0.8 mg L-1 for the same removal efficiency of 90%. These results may help us understand the mechanism by which pressurization treatment impacts M. flos-aquae coagulation and thus provide a new perspective for the low-cost and sustainable removal of cyanobacterial blooms.