Background: Metronidazole (MNZ) is an antibiotic form that is considered as a dangerous environmental pollutant due to its widespread use as growth promoters in livestock and aquaculture operations along with its therapeutic application for humans. Purpose: The objective of this work was to conduct a comparative study between the efficiency of the adsorption and photocatalytic degradation of MNZ in an aqueous solution by using magnesium oxide nanoparticles (MgO NP) under different effects, as well as evaluate the performance, reusability and cost study. Materials and Methods: Several instruments such as XRD, EDX, SEM, and TEM were used to characterize the chemical composition and morphological properties of the synthesized MgO NP, while the GC-MS analysis was used to monitor the degradation pathway of MNZ particles within 180 min. The simple photo-batch reactor was used to investigate the degradation of MNZ under the effect of UV radiation, initial concentration of MNZ, pH, catalyst loading, inorganic salts addition, time, and temperature. Results: The degradation efficiency is mainly divided into two steps: 35.7% for maximum adsorption and 57.5% for photodegradation. Adsorption isotherm models confirmed that the process nature is chemisorption and appropriate Langmuir model, as well as to be a nonspontaneous and endothermic reaction according to the thermodynamic study. Adsorption constant during dark condition is smaller than typical adsorption equilibrium constant derived from the Langmuir-Hinshelwood kinetic model through photodegradation of MNZ that follows pseudo-first-order kinetics. Toxicity rates were reduced considerably after the photodegradation process to 88.21%, 79.84%, and 67.32% and 57.45%, 51.98%, and 43.87% by heamolytic and brine shrimp assays, respectively, for initial MNZ concentrations (20, 60, and 100 mg/L). Conclusion: We significantly recommend using MgO NP as a promising catalyst in the photodegradation applications for other organic pollutants in visible light.