As a conventional adsorption unit, biological activated carbon (BAC) filtration may possess the enrichment risk of emerging contaminants, which is worth investigating in fullscale drinking water treatment plants. This work evaluated the enrichment of antibiotics, heavy metals, and antibiotic resistance genes (ARGs) in full-scale BAC filters and explored the corresponding enrichment mechanisms. The enrichment of antibiotics in BAC filters was observed, with the total contents of 10 detected antibiotics reaching over 400 ng/g. A serious antibiotics leakage of BAC filters was found during the winter with the total concentrations of antibiotics in the water increased from 156.4 ng/ L (influent) to 236.5 ng/L (effluent). According to the redundancy analysis and variation partitioning analysis results, the bacterial community of BAC biofilms was significantly affected by the enriched antibiotics in which roxithromycin contributed the most (31.8%). The enriched antibiotics and heavy metals dominantly contributed to the variation of ARGs in BAC with the explanation of 27 and 20%, respectively. This work revealed that the enriched antibiotics were the key factors affecting the bacterial community and ARGs in BAC and provided a theoretical basis for the optimization of BAC-based water treatment processes.