Due to the increasing use and high excretion rates, high quantities of the antidiabetic drug sitagliptin (STG) enter wastewater treatment plants (WWTPs). In conventional biological treatment, only a moderate removal was achieved, and thus, STG can be detected in WWTP effluents with concentrations in the higher ng/L range. Ozonation is a widely discussed technique for advanced wastewater treatment. In lab-scale experiments, STG showed pH-dependent removal kinetics with a maximum apparent rate constant of k ∼1 × 104 M–1 s–1 at pH ≥ 9. With an apparent rate constant of kO3 = (1.8 ± 0.7) × 103 M–1 s–1 at pH 8, STG can be considered to be readily degraded by ozonation of WWTP effluents. Ozone attacks the primary amine moiety of STG, leading to nitro-STG (TP 437) (the primary amine moiety is transformed into a nitro group). Furthermore, a diketone (TP 406) was formed, which can be further degraded by ozone. Lab-scale and pilot-scale experiments on ozonation of WWTP effluents confirmed that the ozone attack of STG was incomplete even at high ozone doses of 1.7 and 0.9 mg O3/mg DOC, respectively. These experiments confirmed that nitro-STG was formed as the main TP in the wastewater matrix. Two other TPs, TP 421c and TP 206b, were also detected, albeit with low intensities.