The occurrence of sixteen pharmaceutically active compounds in influent and effluent wastewater and in primary, secondary and digested sludge in one-year period has been evaluated. Solid–water partition coefficients (Kd) were calculated to evaluate the efficiency of removal of these compounds from wastewater by sorption onto sludge. The ecotoxicological risk to aquatic and terrestrial ecosystems, due to wastewater discharges to the receiving streams and to the application of digested sludge as fertilizer onto soils, was also evaluated. Twelve of the pharmaceuticals were detected in wastewater at mean concentrations from 0.1 to 32μg/L. All the compounds found in wastewater were also found in sewage sludge, except diclofenac, at mean concentrations from 8.1 to 2206μg/kg dm. Ibuprofen, salicylic acid, gemfibrozil and caffeine were the compounds at the highest concentrations. LogKd values were between 1.17 (naproxen) and 3.48 (carbamazepine). The highest ecotoxicological risk in effluent wastewater and digested sludge is due to ibuprofen (risk quotient (RQ): 3.2 and 4.4, respectively), 17α-ethinylestradiol (RQ: 12 and 22, respectively) and 17β-estradiol (RQ: 12 and 359, respectively). Ecotoxicological risk after wastewater discharge and sludge disposal is limited to the presence of 17β-estradiol in digested-sludge amended soil (RQ: 2.7).