<p>Among the contaminants of emerging concern in contaminated mine drainage (CMD), rare earth elements (REEs) and radionuclides are increasingly studied due to their critical importance in strategic sectors, while their environmental behavior and potential recovery from mine waters are still emergent. This study presents a comprehensive review of emerging biological and chemical treatment methods for the removal of REEs and associated radionuclides from CMD, emphasizing the integration of economic, environmental, and industrial considerations as well as the recovery options of REEs from post-treatment residues. Membrane filtration, (bio)sorption, bioprecipitation, and electrochemical systems are evaluated though a detailed analysis of recent and relevant scientific literature. The findings show that these emerging treatment methods can achieve over 80% removal of REEs and radionuclides, often with satisfactory selectivity over competing cations. These technologies still face limitations, including high costs, energy consumption, adverse environmental effects of chemical use, as well as potentially radioactive post-treatment residue management. The recovery of REEs and, to a lesser extent, radionuclides from post-treatment residues offers potential economic and ecological gains that help mitigate these limitations. More research is needed on the interactions between REEs and radionuclides, improved selective sorption materials or biological processes, as well as the incorporation of life cycle assessments and long-term post-treatment residue management into CMD treatment strategies.</p>