Worldwide, pharmaceutical use has been on the increase for the past century and will continue to increase into the future with the development of new medicines to cure recently discovered diseases as well as previously untreatable conditions. Following use by the patient, active pharmaceutical ingredients (APIs) and their metabolites are excreted to the sewerage system. They are then typically transported to a wastewater treatment works, where, depending on their molecular structure and physicochemical properties, they can be either degraded by biological treatment processes or released to the environment in effluents or sorb to sludge. The soil environment will therefore be exposed to APIs and their metabolites when sludge from treatment processes is applied to land as an agricultural fertilizer or when soil is irrigated with reclaimed wastewater effluent. While only a few studies have explored the occurrence of APIs in the soil environment, available data indicate that a range of API classes, including nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and antibacterial agents do occur in soils in concentrations up to the low mg/kg level. Because of detection of pharmaceuticals in soils, concerns have been raised over the potential for these substances to be taken up into human food items and to pose a risk to human health. A number of studies have demonstrated the uptake of pharmaceuticals used in human and veterinary medicine into plants. Studies have explored the uptake and translocation of a variety of APIs with a particular focus on the antidepressant drug fluoxetine and antibacterial chemicals including sulfamethazine, sulfamethoxazole, and trimethoprim into numerous plant species including root and shoot crops such as soybean, lettuce, and carrot.