Pesticides are widely applied to protect plants from diseases, weeds, and insect damage, and they usually come into contact with soil where they may undergo a variety of transformations and provide a complex pattern of metabolites. Spreading sewage sludge on agricultural lands has been actively promoted by national authorities as an economic way of recycling. However, as a byproduct of wastewater treatment, sewage sludge may contain pesticides and other toxic substances that could be incorporated into agricultural products or be distributed in the environment. This article reviews the determination of pesticides in sewage sludge samples. Sample preparation including pretreatment, extraction, and cleanup, as well as the subsequent instrumental determination of pesticide residues, are discussed. Extraction techniques such as Soxhlet extraction, ultrasound-assisted extraction, pressurized liquid extraction, supercritical fluid extraction, and matrix solid-phase dispersion and their most recent applications to the determination of pesticides in sewage sludge samples are reviewed. Determination of pesticides, generally carried out by GC and HPLC coupled with different detectors, especially MS for the identification and quantification of residues, is summarized and discussed.