Here, we reviewed studies in aquatic animals highlighting that CBZ affected ROS homeostasis but also the neuroendocrine system, cell viability, immunity, reproduction, feeding behavior and growth. Notably, the acetylcholinesterase activity was modified by concentrations of the order of ng L À1 CBZ. At $10 mg L À1 , data pointed that CBZ triggered the production of ROS, modifying the activity of antioxidant enzymes and produced a significant cellular stress at concentrations $100 mg L À1. However, the response appeared species-, organ-and time-dependent, and was impacted by different experimental conditions and the origin of animals. In this context, this review discusses the available data and proposes future research priorities. Environmental signicance Carbamazepine (CBZ) is the drug the most frequently detected in aquatic systems. A current research priority in ecotoxicology is to study subtle chronic effects reducing the health of an individual or population, notably using environmentally relevant exposure scenarios. In this context, the identication of the molecular and cellular toxicity pathways of CBZ is needed to better anticipate its effects at environmental concentration and in complex conditions. Numerous studies present different effects of CBZ from the individual level (growth, reproduction rate) up to the sub-individual level (lipid peroxidation, enzymatic activities or gene relative expression level) in aquatic animals. This review aims to summarize and discuss the scientic literature on effects of CBZ in aquatic animals, with a particular focus on identication of cellular and molecular toxicity pathways in animals exposed through water under conditions that are relevant for environmental impacts. In this context, the present review summarizes the current knowledge of the biological effects exerted by CBZ in aquatic animals aiming to identify molecular and cellular toxicity pathways at environmental concentrations and future research priorities.