The surging growth of clinical and pharmaceutical medication as a consequence of population growth has become a threat to the environment. The inherent antagonistic effects of medications and their metabolized side products on a healthy society is an essential concern requiring immediate monitoring. To speculate on these environmental pollutants, a huge number of selective, sensitive, costeffective, and user-compatible metal−organic framework (MOF)-based fluorescent sensors have been reported by many prominent research groups. Many recent review articles cover the details of MOF-based florescence sensing of antibiotics, but an accumulation of MOF-based fluorometric detection of other pharmaceutical drugs is still not reported. Realizing this research gap, we have discussed most of the reported MOF sensors for various pharmaceutical drugs in this Review. The details of selectivity, sensitivity (limit of detection (LOD) and Stern−Volmer constant (K sv )), response time, and proposed mechanisms of drug sensing have been thoroughly discussed. Moreover, this article also covers the details of a few MOF-based antibiotic sensors, which have not been covered by any previous report. Therefore, this Review will provide valuable information and guidance to researchers to develop targeted fluorescent sensors for hazardous pharmaceutical drugs. Additionally, environmental science researchers can leverage this information to enhance their efforts to monitor and control environmental pollution.