This study investigated the use of nature-based solutions for treating real pharmaceutical industry wastewater in Jordan. A pilot-scale hybrid treatment wetland (TW) equipped with local zeolite was employed, comprising a tidal flow TW and a horizontal subsurface flow TW. This system was efficient in treating pharmaceutical wastewater with removal efficiencies of 61.4%, 52.6%, 60.1%, and 61.9% for chemical oxygen demand, total phosphorus, total nitrogen, and NH4+-N, respectively. The final effluent met Jordanian standards for the reuse of treated wastewater in irrigation (Class B). Five pharmaceuticals, namely, enrofloxacin, ciprofloxacin, ofloxacin, lincomycin, and trimethoprim, demonstrated nearly completed removal (93.6-99.9%). Moderated removal performances (59.2-68.2%) were observed for two compounds, flumequine and sulfaquinoxaline. However, three pharmaceuticals, namely, carbamazepine, diclofenac, and sulfadimidine, showed limited removal performances (1.1-20.5%). This study supported the feasibility of using nature-based solutions for treating pharmaceutical wastewater and highlighted that future studies are required to optimize this strategy for removing a broader range of pharmaceuticals. A pilot-scale hybrid treatment wetland (TW), as a nature-based solution, was constructed in a Jordanian pharmaceutical factory to treat its wastewater. The system achieved removal efficiencies of 61.4%, 52.6%, 60.1%, and 61.9% for COD, TP, TN, and NH4+-N, respectively. Promising removal efficiencies of target pharmaceuticals were also obtained. This study supported the feasibility of using nature-based solutions for treating pharmaceutical wastewater and highlighted that future studies are required to optimize this strategy for removing a broader range of pharmaceuticals.image Treatment wetland (TW) as a nature-based solution can treat pharmaceutical wastewater.Tidal flow TW with a better aerobic condition was favourable for pollutant removal.Jordanian zeolite was a promising wetland media to enhance the treatment performance.The final effluent complied with Jordanian standards for wastewater reuse in irrigation.Some pharmaceuticals could achieve completed removal by the hybrid TW system.