Ecopharmacovigilance monitors medications' environmental effects. Pharmaceuticals are used worldwide, raising worries about their environmental impact and health risks. This review paper summarizes ecopharmacovigilance knowledge. Pharmaceuticals enter the environment through human and animal urine, incorrect disposal, and industrial wastewater discharge. Pharmaceuticals can pollute air, water, and soil. These substances can interact with non-target species and cause ecological problems at different trophic levels. Environmental pharmaceuticals affect aquatic, terrestrial, and microbiological life. Behaviour, growth, reproduction, development, and physiological and biochemical systems are affected. Pharmaceutical exposure disrupts aquatic food webs, endocrine systems, and antibiotic resistance. Pharmaceutical bioaccumulation and biomagnification can affect higher trophic levels. Pharmaceuticals' various chemical characteristics, low concentrations, and complicated matrices make environmental detection and monitoring difficult. HPLC, MS, and immunoassays have been used, but standardization, matrix interferences, and the wide range of medicines in the environment provide challenges. Analytical methodologies for certain pharmacological classes and their transformation products need further development.