Hematite (α-Fe2O3) has gained significant attention as a photocatalyst for wastewater treatment, particularly in the degradation of pharmaceuticals and organic pollutants. Its unique properties, including a suitable band gap of approximately 2.0–2.2 eV, allow for effective utilization of visible light, making it an attractive candidate for sustainable environmental applications. Photocatalytic processes involving hematite generate reactive oxygen species that can efficiently oxidize organic contaminants, converting them into less harmful substances. Recent studies have demonstrated hematite’s effectiveness in degrading various pharmaceutical compounds, achieving notable removal efficiencies under visible light irradiation. However, challenges, such as low charge carrier mobility and high recombination rates of photogenerated electron–hole pairs, limit its overall performance. To enhance its photocatalytic activity, researchers are exploring strategies, such as doping, creating heterojunctions, and optimizing particle morphology to improve charge separation and light absorption. This chapter highlights the current advancements in hematite-based photocatalysts for wastewater treatment and discusses future directions for research aimed at overcoming existing limitations, ultimately contributing to the development of efficient and eco-friendly solutions for water purification.