Contaminants of emerging concern (CEC) such as pharmaceuticals commonly found in urban and industrial wastewater are a potential threat to human health and have negative environmental impact. Most wastewater treatment plants cannot efficiently remove these compounds and therefore, many pharmaceuticals end up in aquatic ecosystems, inducing problems such as toxicity and antibiotic-resistance. This review reports the extent of pharmaceutical removal by individual processes such as bioreactors, advanced oxidation processes and membrane filtration systems, all of which are not 100% efficient and can lead to the direct discharge of pharmaceuticals into water bodies. Also, the importance of understanding biotransformation of pharmaceutical compounds during biological and ultrasound treatment, and its impact on treatment efficacy will be reviewed. Different combinations of the processes above, either as an integrated configuration or in series, will be discussed in terms of their degradation efficiency and scale-up capabilities. The trace quantities of pharmaceutical compounds in wastewater and scale-up issues of ultrasound highlight the importance of membrane filtration as a concentration and volume reduction treatment step for wastewater, which could subsequently be treated by ultrasound.