The fate and removal of 48 pharmaceuticals and personal care products (PPCPs) during anaerobic digestion of sewage sludge were investigated in four full-scale sewage treatment plants (STPs). We measured concentrations in both the liquid and solid phases of the sludge to compare the distribution ratios (K-d) between phases before and after digestion. The results showed changes in K-d values of PPCPs with carboxyl or amino functional groups, probably due to a shift of dissociation equilibrium with the increase in pH. Sulfamethoxazole and trimethoprim were almost completely degraded (>90%); triclosan, triclocarban, and ofloxacin were moderately degraded (around 30-50%); but carbamazepine was not eliminated. To our knowledge, this is the first report that shows (i) the occurrence and removal of several tens of PPCPs by anaerobic sludge digestion in full-scale municipal STPs and (ii) the change of distribution between the liquid and solid phases during digestion. (C) 2013 Elsevier B.V. All rights reserved.