Increasing dependency on pharmaceutical compounds including antibiotics, analgesics, antidepressants, and other drugs has threatened the environment as well as human health. Their occurrence, transformation, and fate in the environment are causing significant concerns. Several existing treatment technologies are there with their pros and cons for the treatment of pharmaceutical wastewater (PWW). Still, electrocoagulation is considered as the modern and decisive technology for treatment. In the EC process, utilizing electricity (AC/DC) and electrodes, contaminants become coagulated with the metal hydroxide and are separated by co-precipitation. The main mechanism is charge neutralization and adsorption of contaminants on the generated flocs. The range of parameters affects the EC process and is directly related to the removal efficiency and its overall operational cost. This process only could be scaled up on the industrial level if process parameters become optimized and energy consumption is reduced. Unfortunately, the removal mechanism of particular pharmaceuticals and complex physiochemical phenomena involved in this process are not fully understood. For this reason, further research and reviews are required to fill the knowledge gap. This review discusses the use of EC for removing pharmaceuticals and focuses on removal mechanism and process parameters, the cost assessment, and the challenges involved in mitigation.