The progress made by medical science during the last century and its positive impact on society are well known. Medicinal products are an important element of the medical practice and their beneficial effects (and side-effects) on human and veterinary health are widely acknowledged. However, the area where we lack a global view is understanding what happens when these medicinal products are discharged into the environment, either through consumption or as unused or expired products. Residues of various types of medicinal products (hormones, anti-cancer, antidepressants, antibiotics, etc.) have been detected in various environmental compartments, such as surface water, groundwater, soil, air, and biota. Such widespread occurrence obviously begs the question whether a concentration of medicinal products in the environment poses a risk for exposed biota or humans. Recent pharmacovigilance legislation in the EU acknowledges that the pollution of waters and soils with pharmaceutical residues is an emerging environmental issue. The European Commission was asked to deliver a report on the scale of the issue, the causes, and possible policy options to mitigate such impacts. More recently, in the framework of the adoption of the Directive regarding priority substances in the field of water policy, the Commission has been asked to develop, instead of the report, a strategic approach to pollution of water by pharmaceutical substances by the end of 2015. This study, together with other relevant studies and reports, will provide the basis to develop that strategic approach. The study covers both human and veterinary medicinal products but personal care products are excluded.