The use of sludge (biosolids) in land application may contribute to the spread of organic micropollutants as wastewater treatments do not completely remove these compounds. Therefore, the development of alternative strategies for sludge treatment is a matter of recent concern. The elimination of pharmaceuticals at pre-existent concentrations from sewage sludge was assessed, for the first time, in nonsterile biopiles by means of fungal bioaugmentation with Trametes versicolor (BTV-systems) and compared with the effect of autochthonous microbiota (NB-systems). The competition between the autochthonous fungal/bacterial communities and T. versicolor was studied using denaturing gradient gel electrophoresis (DGGE) and the cloning/sequencing approach. An inhibitory effect exerted by T. versicolor over bacterial populations was suggested. However, after 21 days, T. versicolor was no longer the main taxon in the fungal communities. The elimination profiles revealed an enhanced removal of atorvastatin-diclofenac-hydrochlorothiazide (during the whole treatment) and ranitidine-fenofibrate (at short periods) in the BTV biopiles in respect to NB biopiles, coincident with the presence of the fungus. For ibuprofen-clarithromycin-furosemide, the elimination profiles were similar irrespective of the system, and with carbamazepine no significant degradation was obtained. The results suggest that a fungal treatment with T. versicolor could be a promising process for the remediation of some pharmaceuticals in complex matrices such as biosolids.