Concerns have been raised about the risks that pharmaceuticals and personal care products (PPCPs) in aquatic environments posed to humans and the environment. In recent years, sand filtration has been used to potentially remove these emerging contaminants from water. However, there has been no review of the effectiveness of this technology to date. This paper presents a brief introduction of sand filtration types, reviews the current progress in PPCPs removal through sand filtration, and discusses the mechanisms behind this process and the combination of granular activated carbon (GAC) and sand as an enhanced sand-GAC filtration technology. Sand filtration achieves a reasonable but highly variable degree of PPCPs removal. Biodegradation and adsorption are the two main mechanisms of PPCPs removal, in particular the biodegradation since adsorption capacity of sand is relatively low. Other processes, such as bio-sorption and indirect adsorption, may also contribute to PPCPs removal. To compensate for the inadequate PPCPs removal through sand filtration, porous GAC has been combined with sand to develop sand-GAC filtration technologies. Serial, dual, and sandwich filters have been investigated, and significant removal enhancement has been observed, due to the strengthened adsorption capacity, suggesting the applicability of these variants. Future research focus, such as investigating the influence of different operational conditions on sand filter performance, obtaining a deeper understanding of the various removal mechanisms, and investigating of long-term performance of the filter used for PPCPs removal, are suggested.