<p>Antibiotic pollution has emerged as a critical concern due to the widespread use of antibiotics, their persistence in the environment, and their detrimental effects on aquatic ecosystems and human health. Therefore, developing and implementing effective strategies to eliminate these contaminants is essential. Metal–organic frameworks (MOFs) have garnered substantial interest in water purification due to their remarkable potential. This paper provides a comprehensive review of MOFs and related nanocomposites, with a particular emphasis on their effectiveness in removing antibiotics from water sources. MOFs stand out due to their unique characteristics, including high porosity, adjustable structures, and crystalline nature, making them exceptional in adsorbing contaminants and functioning as photocatalysts. The paper delves into the mechanisms of adsorption, which include electrostatic interactions, π-π bonding, van der Waals forces, hydrogen bonding, and surface complexation. It also examines the factors influencing adsorption and photodegradation, comparing these techniques to conventional adsorbents, and highlights the superior performance and cost-effectiveness of MOFs. Additionally, the study discusses the challenges, current trends, and future prospects in the field, offering insights that may inspire new researchers to further explore antibiotic removal using MOFs and develop innovative solutions to existing challenges.</p>