Pharmaceutical pollution, defined as the presence of antibiotics, antidepressants, antidiabetics, and other pharmaceuticals in the environment, is a ubiquitous problem. Active pharmaceutical ingredients (APIs), along with their metabolites and excipients, pose a threat to public health, biodiversity, and ecosystems. In response to this environmental challenge, European legislation has been updated to include certain APIs as priority pollutants and to require the installation of advanced wastewater treatment facilities capable of eliminating them. To deliver an effective response to pharmaceutical pollution, we believe it is essential to implement a combination of at-source and end-of-pipe solutions. In addition, cutting-edge biotechnological tools such as gene engineering, omics analysis, biosensors, and microfluidics have yet to realize their full potential in tackling pharmaceutical pollution.