Pollution of the environment by pharmaceuticals is a subject of growing scientific and societal concern. However, few quantitative data have been reported concerning hospital wastewater contamination. Among the different molecules used at hospital, antineoplastic drugs appear to be of special interest, and 5-fluorouracil (5-FU) can be considered as a key compound of this therapeutic class. To monitor this pharmaceutical in hospital wastewater, a highly specific and selective method was developed using gas chromatography tandem mass spectrometry after solid-phase extraction. This sensitive method (limit of quantification = 40 ng L(-1)) was then applied to assess sewage contamination of a middle-size hospital with oncology service located in Paris, France. Native 5-FU was detectable in 12 of the 14 analysed samples. In positive samples, concentration range was measured from 0.09 to 4.0 microg L(-1). Finally, a predicting model for the hospital wastewater concentrations is presented, and results of this model are discussed.