Abstract <p>The rapid advancement of medical science has increased the availability and use of pharmaceutical products. Consequently, pharmaceutical compounds contaminate natural water bodies, raising concerns in global environmental policy. This study examines various types and pathways of aquatic pollution, highlighting the health and ecological risks associated with wastewater discharge into surface waters. When excessive concentrations of contaminants enter rivers, they can alter biodegradation dynamics, reduce aquatic biodiversity, and consequently impair the natural self-purification capacity of water bodies. The study also underscores the importance of monitoring wastewater treatment efficiency through bioindication and biotesting methods. Contemporary scientific research focuses not only on the toxicity of pharmaceuticals but also on their transformation and degradation processes, which remain largely unexplored in terms of their characterization, presence, fate, and effects in natural environments. These findings demonstrate that the environmental risks associated with pharmaceutical compounds and their metabolites should not be overlooked.</p>