The increasing presence of pharmaceuticals, particularly antiretroviral drugs (ARVs), in wastewater has raised concerns regarding their environmental and health impacts. Photocatalysis, driven by advanced photocatalysts, such as coloured TiO2, ZnO, and composites with carbon-based materials, has shown promise as an effective method for degrading these pollutants. Despite significant laboratory-scale success, challenges remain in scaling this technology for real-world applications, particularly in terms of photocatalyst stability, the formation of toxic degradation by-products, and economic feasibility. This paper explores the current state of photocatalytic degradation for ARVDs, emphasizing the need for further research into degradation pathways, the development of more efficient and cost-effective photocatalysts, and the integration of photocatalysis into hybrid treatment systems. The future of photocatalysis in wastewater treatment hinges on improving scalability, reactor design, and hybrid systems that combine photocatalysis with traditional treatment methods to ensure comprehensive pollutant removal. Innovations in catalyst design and reactor optimization are essential for advancing photocatalysis as a viable solution for large-scale wastewater treatment.