Water pollution by pharmaceuticals is widespread, causing both environmental and human health risks. We assess pharmaceutical water pollution from human and veterinary pharmaceuticals at three geographical levels: global, national (considering Germany and the Netherlands) and catchment level (with a case study for the Vecht catchment shared by Germany and the Netherlands). The grey water footprint (GWF), a measure of water pollution in volumetric terms, is estimated from pharmaceutical loads entering the aquatic environment, considering different pollutant sources and pathways. We study different substances depending on data availability, which varies across geographical levels. Results show a global per capita GWF of 1900 m3 yr1 resulting from human consumption of ciprofloxacin. The largest GWFs in both Germany and the Netherlands were found for ethinylestradiol for human and amoxicillin for veterinary use. The estimated per capita GWF from human use of ethinylestradiol is 2300 m3 yr1 for Germany and 11,300 m3 yr1 for the Netherlands. The per capita GWFs of German and Dutch consumers of animal products are 12,900 and 10,600 m3 yr1, respectively. For the Vecht catchment, we estimate the water pollution level per sub-catchment by comparing the GWF to available runoff, which enables us to identify geographic hotspots. In the basin as a whole, GWFs from human and veterinary pharmaceuticals both exceed available runoff. At all levels, pharmaceutical water pollution substantially adds to earlier water footprint studies that excluded this type of pollution, which demonstrates the importance to include pharmaceutics in water footprint studies.