<p>The growing presence of new pollutants in the environment could lead to both direct and indirect water contamination, endangering human and marine health life. Pharmaceutical contaminants are becoming more prevalent in the environment due to their persistence and therefore there is urgent attention to develop necessitating technological interventions to eliminate them. Metal–organic frameworks (MOFs) are a type of crystalline material with a large surface area, significant pore size, and strong chemical structure in environmental settings. Research interest in MOFs has increased recently, as they have proven to be effective in removing pharmaceutical pollutants through the adsorption process. This review highlights the effectiveness of various MOF architectures in removing pharmaceutical pollutants from aqueous environments. The review further elaborates on different synthesis methods, functionalization techniques, and adsorption mechanisms in detail. The study reveals that while there has been significant research on the adsorption of antibiotics and anti-inflammatory agents from water using MOFs, there is a lack of information on other types of pharmaceutical agents that also pose risks to human health in the environment. Moreover, the study reports for the first time detailed literature on the adsorptive removal of antibiotics and anti-inflammatory pollutants from water during the period 2015 to 2024. The current review suggests that more attention should be given to phytonanoparticle-MOF nanocomposites for pharmaceutical waste removal, as this could lead to innovative solutions for water purification systems.</p>