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In this study, solid phase extraction (SPE) coupled with high-performance liquid chromatography-tandem triple quadrupole mass spectrometry (HPLC-MS/MS) was used to track the contamination of 17 benzodiazepines, 14 acidic pharmaceuticals, and 5 neutral pharmaceuticals in 4 hospital wastewater treatment systems and 3 municipal wastewater treatment plants in Guangzhou, Guangdong Province. The results showed that a total of 10 benzodiazepines, 8 acidic, and 3 neutral pharmaceuticals were detected in the hospital wastewater treatment systems