The occurrences, temporal variations and ecotoxicological risks of 38 selected pharmaceuticals from 7 therapeutic classes (i.e. antibiotics, analgesics, anti-inflammatories, beta-blockers, lipid regulators, anticancer agents, and psychiatric drugs) have been observed in the anaerobically treated sludge of the urban wastewater treatment plant (WWTP) in Konya, Turkey. Sampling was carried out to assess the seasonal variations in one year. The total daily wastewater flow rate of the WWTP was approximately 200,000 m3/day, and 140 tons/day of treated sludge were produced. The total concentrations of all pharmaceutical compounds ranged from 280 to 4898 μg/kg of dry matter (dm). The dominant therapeutic class was analgesics and anti-inflammatories (49%), which was followed by antibiotics (31%). Clarithromycin and azithromycin were the most abundant compounds, with concentrations of 1496 μg/kg dm. The total daily pharmaceutical load in the treated sludge was as high as 1.002 kg/day in the winter season, while the annual pharmaceutical mass load that was discharged into the environment was estimated to be approximately 71.6 kg. The use of treated sludge as fertilizer in agricultural lands causes continuous contamination of the terrestrial environment by pharmaceuticals. Five antibiotics (i.e., azithromycin, clarithromycin, erythromycin, sulfamethoxazole, and doxycycline), one analgesic (acetylsalicylic acid) and one beta-blocker (atenolol) in the digested sludge pose acute and short chronic high risks to environment. The highest short chronic risk in the digested sludge-amended soils was determined for azithromycin (RQ: 54.9). To reduce the potential environmental impact of pharmaceuticals, digested sludge should be monitored in terms of the pharmaceutical contents before being applied to soil. Display omitted •Thirty-eight pharmaceuticals were quantified in anaerobically treated sludge.•The most dominant therapeutic class was analgesics and anti-inflammatories.•The annual pharmaceutical mass load discharged into the environment was 71.6 kg.•Seven compounds in the digested sludge posed high risks (RQ > 1).•Azithromycin in the digested sludge-amended soils exhibited high short chronic risk.