Nature-based solutions such as constructed wetlands (CWs) are a cost-effective option to perform wastewater treatment. Multiple studies have already shown that common CW configurations can remove pharmaceutically active compounds (PhACs) from wastewater mainly due to sorption, biodegradation, and photodegradation processes. Even so, recent research has proposed novel CW configurations to improve PhAC removal. This chapter will review existing studies on the three following novel CW approaches: (1) CWs’ filling material modification, (2) biodegradation enhancement, and (3) integration of CWs with intensive wastewater treatment technologies. Waste-to-product filling materials such as biochar and cork can be used to enhance CWs’ adsorption capacities. On the other side, biodegradation can be improved by incorporating microbial fuel cells, forced aeration, or bioaugmentation technologies into CWs. Finally, combinations of CWs with intensive wastewater treatments may offer a wider range of biodegradation pathways for PhACs and a reduction of the resulting transformation products (TPs). Future research on CWs should include the monitoring of TPs, a higher number of PhACs, ecotoxicological effects, and antimicrobial resistance. In addition, one of the main limitations of CW technology is still the high surface area required, which may be solved by future studies combining novel CW technologies. The authors gratefully acknowledge the financial support of the Spanish Ministry of Science, Innovation and Universities under Project CTM2017-91355-EXP and Generalitat de Catalunya for the Beatriu de Pinós grant-programme. Peer reviewed