Many emerging contaminants (ECs) are not currently removed by conventional water treatment methods and consequently, often reach the aquatic environment. In the absence of proper management strategies, ECs can accumulate in water bodies, which poses potential environmental and health risks. This paper critically reviews, for the first time, the reported occurrence and treatment of ECs in the Middle Eastern and North Africa (MENA) region. The paper also provides recommendations to properly manage EC risks. In the MENA region, pharmaceuticals and personal care products (PPCPs) have been detected in surface water, seawater, groundwater, and wastewater treatment plants. A focus on surface water in the published literature suggests that studies are skewed towards worldwide trends, whereas studies on ECs in seawater are of great importance in the study region. The types of PPCPs detected in the MENA region vary, but anti-inflammatories and antibiotics dominate. In comparison, microplastics have mainly been studied in surface waters and seawater with much less focus on drinking water. The majority of microplastics in the region are secondary types resulting from the degradation of larger plastic debris; polyethylene (PE) and polypropylene (PP) fibers are the most frequently detected polymers, which are indicative of local anthropogenic sources. Research progress on ECs varies between countries, having received more attention in Iran and Tunisia. Most MENA countries have now begun monitoring water bodies for ECs; however, studies are still lacking in some countries including Sudan, Djibouti, Syria, Ethiopia, and Bahrain. Based on this review, critical knowledge gaps and research needs are identified. Countries in the MENA region require further research on a broader range of EC types. Overall, water pollution due to the use and release of ECs can be tackled by improving public awareness, public campaigns, government intervention, and advanced monitoring and treatment methods.