Activated carbons are versatile adsorbents that can play a crucial role in the enhancement of wastewater treatment, namely by controlling organic microcontaminants of emerging concern (CECs) and organic matter. These materials have a 100-year market availability, large scientific testing at lab-scale and applicability in consolidated technologies. However, the use of activated carbons at full-scale urban wastewater treatment is still emerging, driven by the increasing awareness on environmental and human threats mainly resulting from CECs. The present chapter reviews the literature on the application of activated carbons in full- or large pilot-scale plants, highlighting the state-of-art knowledge on practical issues on operational set-ups, improvements on water overall quality, and
costs. The selection criteria and properties of the powdered and granular (PAC and GAC) materials used, and the pros and critical aspects of their application, relevant for product development and process optimization, are also analyzed and determine the research needs proposed for a technical, economic, and environmentally sustainable application of activated carbon in full-scale advanced wastewater treatment.