Pharmaceuticals and personal care products (PPCPs) are detected globally at concentrations spanning 0.01 to 94,307 ng/L. Advanced treatment approaches, including advanced oxidation processes and membrane systems, remain capital-intensive and operationally complex. Macroalgae represent a compelling third-generation biomass that does not require arable land, has a rapid growth rate, and yields polysaccharide-rich materials amenable to surface engineering. Following the PRISMA 2020 guidelines and a PECO-structured protocol, 2580 Scopus records (2000–2026) were screened independently via Covidence. Bibliometric mapping was subsequently performed using VOSviewer. Data extraction included adsorbent preparation, BET surface area, adsorption capacity, kinetic and isotherm parameters, thermodynamic analysis, and adsorbent regeneration performance. Chemical activation was identified as the primary determinant of adsorption performance, with KOH and K₂CO₃ activation yielding specific surface areas up to 2641 m2/g, while H₃PO₄ activation generated mesoporous structures. Langmuir Qmax values reported ranged from 4.32 to 970.88 mg/g for more than 19 PPCP classes. Among the research reported, both textural and quantitative surface-chemistry data under comparable single-adsorbate conditions, variation in surface functional groups was more consistently associated with PPCP uptake than variation in BET surface area. In the studied dataset. Adsorption was predominantly attributed to π–π electron donor–acceptor interactions and hydrogen bonding. A pattern showed up in some, but not all, of the studies that tested adsorption at different temperatures: antibiotics tended to adsorb better as temperature increased (an endothermic process, driven mainly by entropy), while NSAIDs tended to adsorb better as temperature fell (an exothermic process, driven mainly by enthalpy). Column adsorption and real wastewater studies, competitive multi-PPCP testing, and life-cycle assessment remain only briefly reported, collectively defining the translational gap that must be addressed to advance macroalgal biochar toward deployment as sustainable PPCP remediation technology.