Abstract This paper presents a comprehensive review of the current state of research activities on the application of constructed wetlands for removing pharmaceutical contaminants from wastewater. The focus of the review was placed on the application of constructed wetlands as an alternative secondary wastewater treatment system or as a wastewater polishing treatment system. The design parameters of the reported constructed wetlands including the physical configuration, hydraulic mode, vegetation species, and targeting pharmaceuticals were summarized. The removal efficiencies of pharmaceuticals under different conditions in the wetlands were evaluated at the macroscopic level. In addition, the importance of the three main components of constructed wetlands (substrate, plants and microbes) for pharmaceutical removal was analyzed to elucidate the possible removal mechanisms involved. There is a general consensus among many researchers that constructed wetlands hold great potential of being used as an alternative secondary wastewater treatment system or as a wastewater polishing treatment system for the removal of pharmaceuticals, but relevant reported studies are scarce and are not conclusive in their findings. Current knowledge is limited on the removal efficiencies of pharmaceuticals in constructed wetlands, the removal mechanisms involved, the toxicity to constructed wetlands caused by pharmaceuticals, and the influences of certain important parameters (configuration design, hydraulic mode, temperature and seasonality, pH, oxygen and redox potential, etc.). This review promotes further research on these issues to provide more and better convincing evidences for the function and performance of larger laboratory-scale, pilot-scale or full-scale constructed wetlands.