Sludge generated at sewage treatment plants is of environmental concern due to the voluminous production and the presence of a high concentration of emerging contaminants (ECs). This review discusses the fate of ECs in sewage sludge treatment with an emphasis on fundamental mechanisms driving the degradation of compounds based on chemical properties of the contaminant and process operating conditions. The removal of ECs in sewage sludge through various treatment processes of sludge stabilization, such as anaerobic digestion (AD), composting, and pre-treatment methods (thermal, sonication, and oxidation) followed by AD, are discussed. Several transformation mechanisms and remediation strategies for the removal of ECs in sludge are summarized. The study concludes that pH, sludge type, and the types of functional groups are the key factors affecting the sorption of ECs to sludge. During conventional waste stabilization processes such as composting, the degradation of ECs depends on the type of feedstock (TOC, N, P, C/N, C/P) and the initial concentration of the contaminant. In AD, the degree of degradation depends on the hydrophilicity of the compound. The estrogenicity of the sludge may sometimes increase due to the conversion to estrogenic compounds. The pre-treatment techniques can increase the partitioning of ECs in the soluble fraction resulting in enhanced biodegradation up to 10–60%. However, the formation of by-products and loss of OH· to scavenging under high organic content during advanced oxidation processes can make the process uneconomical and require further research. ... Read more