In the current study a high sensitive analytical method was developed for the determination of 60 steroids including glucocorticoids (GC), mineralocorticoids (MC), and progestogens (PG) in WWTP effluents and surface water using liquid chromatography with tandem mass spectrometry detection (LC-MS/MS). The limits of quantification (LOQ) ranged between 0.02 ng/L (cortisone) to 0.5 ng/L (drospirenone) in surface water and from 0.05 ng/L (betamethasone) to 5 ng/L (chlormadinone) in treated wastewater. After optimization, the developed method was applied to WWTP effluents, rivers, and streams around Germany. Numerous steroids have been detected during the sampling campaign and predominant analytes from all steroid types were determined. Moreover, the occurrence of dienogest, mometasone furoate, flumethasone pivalate, and the metabolites 6β-hydroxy dienogest, 6β-hydroxy triamcinolone acetonide, 7α-thiomethyl spironolactone, and 11α-hydroxy canrenone is reported for the first time. In addition, this study revealed the ubiquitous presence of topically applied GC monoesters betamethasone propionate, betamethasone valerate, and 6α-methylprednisolone propionate in WWTP effluents and surface water.