China is a significant global producer and consumer of pesticides and antibiotics, with their excessive use leading to substantial water pollution that poses challenges for subsequent treatment. Photocatalytic degradation, leveraging renewable solar energy, presents an effective approach for decomposing organic pollutants and reducing residual contaminant levels in water bodies. This approach represents one effective way for addressing environmental challenges. This paper classifies representative photocatalytic materials by structural design and degradation principles including MOFs (Metal–Organic Frameworks), metal- and nonmetal-doped, mesoporous material-loaded, carbon quantum dot-modified, floatation-based, and heterojunction photocatalysts. We also discuss research on degradation pathways and reaction mechanisms for antibiotics. Of particular importance are several key factors influencing degradation efficiency, which are summarized within this work. These include the separation and charge transfer rate of catalyst surface carriers, and the wide-spectrum response capabilities of photocatalysts, as well as persulfate activation efficiency. Furthermore, emphasis is placed on the significant role played by intrinsic driving forces such as built-in electric fields within catalytic systems. Moreover, this paper introduces several promising composite-structure photocatalytic technologies from both composite-structure perspectives (e.g., Aerogel-based composites) and composite-method perspectives (e.g., the molecularly imprinted synthesis method). We also discuss their latest development status, along with future prospects, presenting valuable insights for pollutant degradation targets. This work aims to facilitate the design of efficient photocatalytic materials, while providing valuable theoretical references for environmental governance technologies.