Antimicrobial resistance (AMR) in aquatic environments is a pressing global concern with far-reaching implications for public health and ecosystem sustainability. This mini-review explores the intricate pathways through which antibiotics enter water bodies, highlighting the substantial contributions of aquaculture facilities, untreated wastewater discharge, and agricultural practices to the spread of antibiotic-resistant bacteria (ARB) and resistance genes (ARGs). By systematically reviewing over 121 peer-reviewed articles, the role of hospital wastewaters as vectors for AMR dissemination is emphasized, highlighting the challenges posed by the persistence of antibiotics through various treatment processes. Advanced treatment technologies, such as membrane filtration and activated carbon adsorption, have been identified as effective in mitigating the risks associated with emerging pollutants in wastewater. The study further emphasizes the interconnectedness between environmental factors, hydrological dynamics, and the behavior of ARGs in water bodies, necessitating a comprehensive approach to wastewater treatment and AMR mitigation. Key recommendations include optimizing biological treatment processes, enhancing monitoring and surveillance programs, and promoting public awareness to combat the proliferation of AMR in aquatic ecosystems. Addressing AMR in water sources requires collaborative efforts, innovative solutions, and a commitment to upholding global health standards.