Constructed wetlands (CWs) are increasingly considered for secondary wastewater treatment, removing both conventional contaminants and emerging pollutants, notably pharmaceutical and personal care products (PPCPs). However, the CW design and operational conditions to biodegrade PPCPs as micropollutants may promote greenhouse gas (GHG) emissions, raising sustainability concerns. This meta-analysis investigates the relationship between PPCP removal (caffeine, ibuprofen, naproxen, diclofenac, ketoprofen, carbamazepine, sulfonamide compounds) and GHG emissions (methane, carbon dioxide, nitrous oxide) in CWs. We uniquely integrate two sets of studies, as prior research has not linked PPCP biodegradation with GHG emissions. Data from 26 papers identify factors driving PPCP removal and 26 publications inform GHG emission factors. Spearman's correlation coefficient and multiple linear regression assess parameter effects and interlinkages. Results highlight biological processes, particularly secondary metabolism or co-metabolism, as pivotal for PPCP removal and GHG emissions, with inlet PPCP concentration, carbon load, and temperature being significant influencers (p < 0.05). Challenges persist in optimizing operations to improve PPCP removal and abate GHG emissions simultaneously. Still, CW depth, influent chemical oxygen demand (COD), hydraulic retention time, and subsurface flow wetland configuration emerge as strategic parameters. This study underscores the need for integrated approaches to enhance PPCP removal and decrease GHG emissions in CWs, thereby advancing sustainable water management practices.