The fate of 28 trace organic compounds (TrOCs) was investigated in the hyporheic zone (HZ) of an urban lowland river in Berlin, Germany. Water samples were collected hourly over 17 h in the river and in three depths in the HZ using minipoint samplers. The four relatively variable time series were subsequently used to calculate first-order removal rates and retardation coefficients via a one-dimensional reactive transport model. Reversible sorption processes led to substantial retardation of many TrOCs along the investigated hyporheic flow path. Some TrOCs, such as dihydroxy-carbamazepine, O-desmethylvenlafaxine, and venlafaxine, were found to be stable in the HZ. Others were readily removed with half-lives in the first 10 cm of the HZ ranging from 0.1 ± 0.01 h for iopromide to 3.3 ± 0.3 h for tramadol. Removal rate constants of the majority of reactive TrOCs were highest in the first 10 cm of the HZ, where removal of biodegradable dissolved organic matter was also the highest. Because conditions were oxic along the top 30 cm of the investigated flow path, we attribute this finding to the high microbial activity typically associated with the shallow HZ. Frequent and short vertical hyporheic exchange flows could therefore be more important for reach-scale TrOC removal than long, lateral hyporheic flow paths.