Direct discharge of treated effluent containing pharmaceuticals compounds (PCs) to natural water bodies raised concern regarding the effect of these persistent (escaped) compounds on the aquatic ecosystem. The presence of these PCs in the receiving environment causes disturbance of aquatic flora and fauna and risk to human health. Our study was concerned about removal efficiency of the removal comparing to Egyptian guidelines. Conventionally treated methods as physical, chemical, biological and reverse osmosis technologies were tested. The effectiveness of this system was verified by observing the effluent content such as microbial load during an operation period and total element content by ICP-MS. A result of adjusting pH and start mixing with sewage waste water showed the values for different item were decreased by 81%, 89 %, 63%, 52%, 44%, 95%, and 44 % for BOD, COD, TSS, oil and grease, TP, TPH and H2S, respectively. The results showed the optimum removing for contamination between (16 hours to 36 hour) from start treatment, and the optimum pH ranged from 7 to 8 in case for biological treatment of pharmaceutical waste water and TDS decreased by 69 % by RO system.