We present a two-step methodology for the preparation of highly activated carbons with tailored morphologies and micropore size distributions (MPSD) through the hydrothermal carbonization (HTC) of renewable biomass – sucrose – and further activation. Depending on the activation agent, activated carbons with spherical (K2CO3 or steam activation) or sponge-like morphologies (KOH activation) were obtained. The control of the activation variables allows tailoring the MPSD of the materials, with K2CO3 activation at 700 – 800 ºC originating porous materials with molecular sieve properties and KOH activation giving porous carbon materials with wider MPSD. The highly developed porous structures of the activated carbons give them remarkable adsorption capacities for the removal of pharmaceutical compounds of distinct therapeutical classes (i.e. ibuprofen, paracetamol, clofibric acid, caffeine and iopamidol). While the superactivated carbon obtained by KOH activation at 800 ºC has very high adsorption capacities for all the pharmaceutical compounds assayed the material obtained by K2CO3 activation at 800 ºC has similar adsorption capacity for all pharmaceuticals but iopamidol, the most voluminous compounds. The distinct performance of the porous carbons materials for the removal of the pharmaceutical compounds is mainly related to their MPSD. The high performance of some of the synthetized carbons allied to the possibility of controlling the size of the particles in the HTC step allows envisaging their use as filter media but also coupled to other advanced water treatment technologies (e.g. membrane systems). Moreover, the above mentioned properties associated with the acidic surface chemistry of the developed activated carbons opens new possibilities for the synthesis of functional carbon-based materials.