Chemical pollution is a threat to coral reefs. To preserve them, it is crucial to monitor novel contaminants and assess the related risks. The occurrence of active pharmaceutical ingredients (APIs) in coral reefs has been poorly investigated until now. Under this light, we tested the use of the marine sponge Cf. Hyrtios as bio-monitors and conducted a pilot study in the Faafu Atoll (Maldives). Analyses were carried out by in vivo solid-phase microextraction (SPME) and liquid chromatography (LC) electrospray ionization (ESI) tandem mass spectrometry (MS/MS). Twelve APIs were selected for method optimization. Limits of quantitation (LOQs) were in the 0.6 and 2.5 ng/g range, accuracy between 86.5 % and 104.7 %, and precision between 3.0 % and 14.9 %. All the sponges located in the inner reefs resulted contaminated with at least one API. Gabapentin and Carbamazepine displayed the highest detection rates, while Ketoprofen had the highest concentration (up to 15.7 ng/g).