Increasing human activities, a great demand for animal protein and intensive use of antibiotics, are responsible for the persistent emergence of antibiotic contaminants in the environment. Increased attention has been paid to this pollution because it possibly exacerbates the appearance of antibiotic resistance bacteria and antibiotic resistance genes. Hence, the effective removal of antibiotic pollutants has become a hot topic in environmental research. Bioelectrochemical systems (BESs) coupled with microbial metabolisms and electrochemical redox reactions are considered to be promising alternatives for the degradation of antibiotics contaminants. In this review, state-of-the-art BESs for enhanced antibiotics removal are described and antibiotics removal mechanisms based on BESs are reviewed. The effects of typical parameters, such as the electrochemical properties and initial concentration of antibiotics, applied potential, electrode material, carbon source, temperature, and salinity, on the overall performance of such systems are elaborated. Degradation pathways and metabolic byproducts of antibiotics related to BESs processes are also reported. Additionally, predominant microbes responsible for several representative antibiotics are demonstrated and their evolution factors are tabulated and discussed. Furthermore, the effect of the temperature, salinity, initial antibiotic concentration, and potential applied in BESs on the fate of antibiotic resistance genes is disclosed. Finally, an outlook on future applications and challenges is provided, which is conducive to the development of BESs for the treatment of wastewater containing antibiotics.