Soil dwelling organisms, plants and many primary consumers in food webs face the challenge of exposure to contaminants of emerging concern (CECs) present in terrestrial systems, including thousands of substances derived from pharmaceutical and personal care products (PPCPs). The recent increase in the consumption of modern human or veterinary drugs has resulted in a surge of anthropogenic pharmaceuticals, frequently introduced into terrestrial environments via untreated/treated wastewater. Pharmaceuticals display diverse degradation and accumulation behaviours in receiving bodies, however their impact on soils has, at large, been overlooked. Details about adsorption, absorption, degradation and uptake behaviours, as well as the fate and actual environmental impact of pharmaceuticals are a prerequisite before the traditional transportation prediction models originally designed for the aquatic environment can be extrapolated to terrestrial systems. Without this knowledge, our ability for informed risk assessments and the resultant implementation of contamination management strategies of soils will remain limited. This review discusses the current knowledgebase pertaining the introduction of pharmaceuticals to soils via wastewater irrigation or the application of biosolids. The focus on the transportation, transformation and accumulation of pharmaceuticals through the food chain highlights the urgent need to strengthen our capabilities concerning their detection and characterization in the terrestrial ecosystem.