Municipal wastewaters contain a multitude of organic trace pollutants. Often, their biodegradability by activated sludge microorganisms is decisive for their elimination during wastewater treatment. Since the amounts of micropollutants seem too low to serve as growth substrate, cometabolism is supposed to be the dominating biodegradation process. Nevertheless, as many biodegradation studies were performed without the intention to discriminate between metabolic and cometabolic processes, the specific contribution of the latter to substance transformations is often not clarified. This minireview summarizes current knowledge about the cometabolic degradation of organic trace pollutants by activated sludge and sludge-inherent microorganisms. Due to their relevance for communal wastewater contamination, the focus is laid on pharmaceuticals, personal care products, antibiotics, estrogens, and nonylphenols. Wherever possible, reference is made to the molecular process level, i.e., cometabolic pathways, involved enzymes, and formed transformation products. Particular cometabolic capabilities of different activated sludge consortia and various microbial species are highlighted. Process conditions favoring cometabolic activities are emphasized. Finally, knowledge gaps are identified, and research perspectives are outlined.