Presently, many pharmaceuticals are listed as emerging contaminants since they are considered to be great potential threats to environmental ecosystems. These contaminants, thus, present significant research interest due to their extensive use and their physicochemical and toxicological properties. This review discusses a whole range of findings that address various aspects of the usage, occurrence, and potentially environmental risks of pharmaceuticals released from various anthropogenic sources, with emphasis on the aquatic systems in Vietnam. The published information and collected data on the usage and occurrence of antibiotics and synthetic hormone in effluents and aquatic systems of Vietnam is reported. This is followed by a potential ecological risk assessment of these pollutants. The extensive use of antibiotics and synthetic hormones in Vietnam could cause the discharge and accumulation of these contaminants in the aquatic systems and potentially poses serious risks for ecosystems. Vietnam is known to have extensively used antibiotics and synthetic hormones, so these contaminants are inevitably detected in aquatic systems. Thus, an appropriate monitoring program of these contaminants is urgently needed in order to mitigate their negative effects and protect the ecosystems.