Reclaimed water is an important source of irrigation and is widely used on agricultural soils throughout the world, particularly in arid and semi-arid regions. However, concerns about the potential risks of this practice are rapidly increasing because reclaimed water may contain various organic pollutants such as pharmaceuticals and personal care products (PPCPs). Trace levels of PPCPs have been found in fields irrigated with reclaimed water, and continual infusion, along with bioaccumulation properties, may result in significant bio-uptake and PPCP contamination in agricultural soils. This review attempts to summarize the literature concerning the fate and behavior of PPCPs in agricultural soils, as well as their adverse effects on soil organisms (including microorganisms and fauna), crops, and even humans via dietary consumption. Strategies and potential technologies for degrading or removing PPCPs from soils are addressed, along with the irrigation strategies and agricultural practices for minimizing PPCP transfer to crops and groundwater. Based on this review, we conclude that the agricultural risks of PPCPs associated with reclaimed water irrigation could be controlled under certain agro-ecological conditions. We suggest developing agro-ecosystem specific practices and regulations for reclaimed water irrigation on the basis of a systematic assessment and modeling analysis of the fate, transport, accumulation, and transformation of PPCPs in soil-crop systems.