Water scarcity is one of the main problems faced by many countries. In order to increase water supply in some regions, reuse of wastewater is proposed. With the purpose of obtaining safe water, more treatment has to be used. Among other pollutants, pharmaceutically active compounds and their metabolites are frequently detected in water subjected to conventional treatments. To remove them, advanced treatments should be used. Some of them are still at lab scale while others are used already at real scale. Here we review the occurrence and fate of pharmaceuticals in wastewater treatment plants with conventional treatment and also in advanced treatments applied at lab and real scale to treat wastewater.