Moving bed biofilm reactors have shown promising results to remove micropollutations (MPs) from wastewater. MPs fall into several groups of chemicals such as pharmaceuticals, organophosphorus pesticides (OPs), care products and endocrine disruptors.  A 2012 article reported described the use of MBBR technology to remove pharmaceuticals such as beta-blockers, analgesics, anti-depressants, and antibiotics from hospital wastewater. Moreover, application of MBBR as a biological technique combined with chemical treatment has attracted a great deal of attention for removal of organophosphorous pesticide from wastewater. The advantage of MBBRs can be associated with its high solid retention time, which allows the proliferation of slow-growing microbial communities with multiple functions in biofilms. The dynamics of such microbial communities greatly depends on organic loading in MBBR systems.
Moving bed biofilm reactors can efficiently treat hospital wastewater and remove pharmaceutical micropollutants. A 2023 study has shown that a strictly anaerobic MBBR, combined with an aerobic biofilm reactor can achieve high removal rates of pharmaceuticals, such as metronidazole, trimethoprim, sulfamethoxazole, and valsartan.