Constructed wetlands (CWs) are nature-based solutions for treating domestic and livestock wastewater which may contain residual antibiotics concentration. Antibiotics may exert selection pressure on wetland's microbes, thereby increasing the global antibiotics resistance problems. This review critically examined the chemodynamics of antibiotics and antibiotics resistance genes (ARGs) in CWs. Antibiotics affected the biogeochemical cycling function of microbial communities in CWs and directly disrupted the removal efficiency of total nitrogen, total phosphorus, and chemical oxygen demand by 22%, 9.3%, and 24%, respectively. Since changes in microbial function and structure are linked to the emergence and propagation of antibiotic resistance, antibiotics could adversely affect microbial diversity in CWs. The cyanobacteria community seemed to be particularly vulnerable, while Proteobacteria could resist and persist in antibiotics contaminated wetlands. Antibiotics triggered excitation responses in plants and increased the root activities and exudates. Microbes, plants, and substrates play crucial roles in antibiotic removal. High removal efficiency was exhibited for triclosan (100%) > enrofloxacin (99.8%) > metronidazole (99%) > tetracycline (98.8%) > chlortetracycline (98.4%) > levofloxacin (96.69%) > sulfamethoxazole (91.9%) by the CWs. This review showed that CWs exhibited high antibiotics removal capacity, but the absolute abundance of ARGs increased, suggesting CWs are potential hotspots for ARGs. Future research should focus on specific bacterial response and impact on microbial interactions.