The present work describes the development of a fully automated method, based on on-line solid-phase extraction (SPE)-liquid chromatography-electrospray-tandem mass spectrometry (LC-MS-MS), for the determination of 74 pharmaceuticals in environmental waters (superficial water and groundwater) as well as sewage waters. On-line SPE is performed by passing 2.5 mL of the water sample through a HySphere Resin GP cartridge. For unequivocal identification and confirmation two selected reaction monitoring (SRM) transitions are monitored per compound, thus four identification points are achieved. Quantification is performed by the internal standard approach, indispensable to correct the losses during the solid phase extraction, as well as the matrix effects. The main advantages of the method developed are high sensitivity (limits of detection in the low ng L(-1) range), selectivity due the use of tandem mass spectrometry and reliability due the use of 51 surrogates and minimum sample manipulation. As a part of the validation procedure, the method developed has been applied to the analysis of various environmental and sewage samples from a Spanish river and a sewage treatment plant.