Acetaminophen (ACT), a common drug pollutant, has been effectively removed from wastewater by a novel adsorbent called La/Th-MOF. This adsorbent is made of stacked nanorods of 2-methyl imidazole with lanthanum and thorium. La/Th-MOF, which is characterized by sophisticated techniques including SEM, XRD, and BET analysis, has a mesoporous assembly with a 1.23 nm pore size and a capacious surface area of 2226.93 m2/g, which facilitates effectual adsorption. The adsorption tests, which were impacted by factors such as pH levels, ACT concentration, and contact time, fit into a pseudo-second-order chemisorption kinetic model and with the Langmuir isotherm, suggesting homogenous monolayer adsorption. The material in question demonstrated a noteworthy maximum adsorption capability of 339.75 mg/g for ACT, indicating its probable as a feasible and economical adsorbent for the mitigation of pharmaceutical contamination in wastewater. Our results designate that pH levels have an important influence on the efficacy of ACT absorption by La/Th-MOF, with an acidic pH 5 environment being most favorable for maximal adsorption at a material dosage of 0.02 g. It was discovered that the adsorption procedure was endothermic. Using pseudo-second-order kinetic models and the Langmuir isotherm, which both fit the experimental data very well, to explain the adsorption kinetics. A chemisorption mechanism was found to be predominant throughout the process, as specified by the predicted adsorption energy of 22.62 kJ/mol. In addition, optimized the influencing parameters by using the Box-Behnken design (BBD) and response surface methodology (RSM), which improved process efficiency. La/Th-MOF, has a remarkable half-life, as demonstrated by six rounds of adsorption and desorption without a discernible decline in performance. Research endeavors aimed at elucidating the interplay between La/Th-MOF and ACT hint to several plausible points of contact that could contribute to the adsorption procedure, such as hydrogen bonding, π-π interactions, pore filling or electrostatic forces. This study, which is innovative in its use, reveals the exceptional efficacy of La/Th-MOF in wastewater purification using ACT extraction. An astounding 339.75 mg/g of optimal adsorption capability was attained at an acidic pH of 5. This highlights how the La/Th-MOF can be used in practice to treat pharmaceutical pollutants found in water sources.