The release of antibiotic pharmaceutical wastewater has caused a serious environmental problem. In order to provide a better guideline for the antibiotic wastewater treatment, this paper summarizes a critical review on the current biological technologies available for antibiotic wastewater degradation, including aerobic processes, anaerobic processes, anaerobic-aerobic processes, and other combined processes. Furthermore, applications of the antibiotic wastewater biological treatment processes are discussed as well.