A sensitive analytical method has been developed and validated for simultaneous determination of pharmaceuticals from different therapeutic classes, i.e. five sulfonamide (SA) and trimethoprim antimicrobials and the anti-inflammatory drug diclofenac, in effluent wastewaters at trace levels. Effluent samples from treatment of wastewater were enriched by solid-phase extraction (SPE) using the Waters Oasis HLB cartridge. The analytes were identified and quantified by reversed-phase liquid chromatography-tandem mass spectrometry operated in the selected reaction monitoring (SRM) mode, using positive electrospray ionization. The pharmaceuticals were, consequently, quantified both by use of isotopically labelled internal standards and by standard addition methods to address the issue of matrix effects related to signal suppression by co-eluting compounds. Average recoveries from fortified samples were usually >70%, with relative standard deviations below 20%. Method detection limits in wastewater matrices were between 7.0 and 10 ng L(-1). Identification points (IPs) were used for unequivocal identification of target analytes in real samples. Diclofenac, trimethoprim, and sulfamethoxazole were mainly detected, in the concentration range 10 to 400 ng L(-1), in effluent samples collected from four different sewage-treatment plants in Greece.