The occurrence and fate of pharmaceuticals in the aquatic environment is recognized as one of the emerging issues in environmental chemistry. Conventional wastewater treatment plants (WWTPs) are not designed to remove pharmaceuticals (and their metabolites) from domestic wastewaters. The treatability of pharmaceutical compounds in WWTPs varies considerably depending on the type of compound since their biodegradability can differ significantly. As a consequence, they may reach the aquatic environment, directly or by leaching of the sludge produced by these facilities. Currently, the technologies under research for the removal of pharmaceuticals, namely membrane technologies and advanced oxidation processes, have high operation costs related to energy and chemical consumption. When chemical reactions are involved, other aspects to consider include the formation of harmful reaction by-products and the management of the toxic sludge produced. Research is needed in order to develop economic and sustainable treatment processes, such as bioremediation and biosorption. The use of low-cost materials, such as biological matrices (e.g., algae and fungi), has advantages such as low capital investment, easy operation, low operation costs, and the non-formation of degradation by-products. An extensive review of existing research on this subject is presented.