The occurrence and behavior of carbamazepine (CBZ) was investigated in aquatic environment of Yangtze River Delta, East China. The water samples were enriched by solid-phase extraction and analyzed by high-performance liquid chromatography with diode array detector. The validation of the analytical method included linearity (0.1-1 mg/L), recovery studies, and determination of limits of quantification. Limits of quantification of CBZ in various aquatic samples were in the range of 0.1-0.2 μg/L. CBZ was detected in the Tongji University Intramural River, the Huangpu River, and the Suzhou River with the highest concentration of 1,090 ng/L, but not detected in the Nanhengyin River and the Caojia River. In sewage water samples, CBZ was not detected in one of the sewage treatment plants (STPs) but was detected in the raw influents and effluents at the other three selected STPs in Shanghai, with the concentrations ranging from 230 to 1,110 ng/L. CBZ was not completely eliminated after secondary treatment (with the active sludge process).