Antibiotic residues in aquatic environments pose significant challenges when exceeding permissible limits. Zeolites, particularly aluminosilicate zeolites, have emerged as effective adsorption materials and solid substrates for semiconductor photocatalysts, facilitating the removal of antibiotics from wastewater. This review highlights the versatility of zeolites and their composites in antibiotic remediation, showcasing recent advancements in adsorption and photocatalytic degradation. Noteworthy examples include Fe (III)-modified synthetic zeolite 13X, exhibiting a maximum tetracycline adsorption capacity of approximately 200 mg/g, and MoS2@Zeolite achieving a remarkable efficiency of 396.70 mg/g for tetracycline removal. Additionally, zeolite-based photocatalysts like Fe-TiO2/BEA zeolite and exceptional CdS/CaFe2O4-clinoptilolite demonstrate high removal percentages, reaching 100% for tetracycline and 86% for cefazolin, respectively. The discussion encompasses an introduction to zeolites, including synthetic and natural zeolites, as well as techniques for modifying natural zeolites. It further delves into the production of synthetic zeolites as well as the fabrication of zeolite-based composite materials. These findings underscore the potential of zeolites and their composites as novel remediation agents for tackling antibiotic contamination in aquatic ecosystems, paving the way for sustainable wastewater treatment strategies. It highlights key elements, distinct qualities, and areas needing further research, paving the way for future studies.