Cow manure (CM) is one of the largest secondary sources of phosphorus, while mined phosphorus rock is becoming scarce and diminishing in quality. Phosphorus recovery from CM is essential for increasing the phosphorus use efficiency and, therefore, securing future food production. Calcium phosphate (CaP) granulation can enable efficient phosphorus recovery during anaerobic digestion. However, in CM, the absence of phosphorus in the ionic form and the high presence of inorganic carbon and magnesium inhibits CaP granulation. In this study, CaP granulation was achieved for the first time during CM treatment, using an up-flow anaerobic sludge blanket (UASB) reactor preceded by an acidifying continuously stirred tank reactor (CSTR). The UASB reactor and CSTR ran for 190 days at organic loading rates of 1 and 22.5 gCOD L_reactor^-1 d^-1, respectively. The acidification of CM at pH 5 dissolved struvite and calcium carbonate, causing > 94% of phosphorus, calcium and magnesium to be present as ions. In the UASB reactor fed with the CSTR effluent, 83 ± 3% of phosphorus was removed and mainly present as CaP granules > 2.5 mm in diameter. The CaP granules had a phosphorus content of 8.4 ± 1.3%P w/w with amorphous and crystalline calcium phosphate being the dominant phases. The formation of large and concentrated CaP granules causes accumulation at the bottom of the reactor and allows for simple size separation leading to efficient phosphorus recovery The recovery of CaP granules improves CM valorization and can reduce the transport of manure by up to 87%. The acidification prior to digestion thus promotes a more efficient use of phosphorus from CM in agriculture and can replace phosphorus from primary phosphorus sources.