Abstract: Large-scale antibiotic production and inappropriate use continue to increase antibiotic discharges into aquatic environments, driving the increasing co-contamination of water bodies by antibiotics and antibiotic resistance genes (ARGs) and posing a substantial threat to ecosystem stability and human health.Conventional wastewater treatment technologies, however, still show limited capacity for removing these emerging contaminants and may, under certain conditions, even promote the development and dissemination of antimicrobial resistance (AMR), thereby further increasing environmental risk. By comparison, advanced oxidation processes (AOPs) enable the efficient degradation of organic pollutants through the generation of highly reactive oxidative species.They also show clear advantages in disrupting antibiotic molecular structures and damaging genetic material, making them a promising option for the advanced treatment of waters contaminated by antibiotics and ARGs. This review summarises the occurrence and current pollution status of antibiotics and ARGs in aquatic environments, examines the reaction pathways and underlying mechanisms of AOPs based on hydroxyl radicals, sulphate radicals, and emerging non-radical pathways, evaluates the removal performance of individual AOPs and their coupled systems for antibiotics and ARGs, and discusses the key factors affecting treatment efficiency, thereby providing a useful theoretical basis and reference for future research in this field.