The present study evaluates the presence of nine hormones and their conjugates and 20 pharmaceuticals such as anti-inflammatories, lipid regulators, and antibiotics among others in sewage sludge from two sewage treatment plants (STPs) in the Tarragona area (Spain) for the period March 2007 until March 2008. Target analytes have been determined using different methods involving pressurized liquid extraction and liquid chromatography (electrospray ionization) tandem mass spectrometry (MS-MS). Most of the pharmaceuticals and hormones were found at low micrograms per kilogram dry weight levels in the sewage sludge samples analyzed. Some compounds were present in all samples, such as acetaminophen, caffeine, carbamazepine, and ibuprofen, among others. Other compounds, such as estriol, were found only in the STP of Reus. The compounds that showed the highest concentration in both STPs were roxithromycin and tylosin (1,446 and 1,958 µg/kg dry wt, respectively). The presence of these compounds in sewage sludge demonstrated that they are partially or totally removed from the influent wastewater by sorption into the sewage sludge. Environ. Toxicol. Chem. 2010;29:1484–1489. © 2010 SETAC