The rigorous production and consumption of antibiotics globally have necessarily resulted in enormous volumes of these drugs being released into the environment, and several strategies have lately been proposed to reduce antibiotic contamination. As a result, bismuth-based photocatalysts have received more consideration due to their low production cost and higher visible light adsorption. The diverse structures and morphologies of bismuth-based compounds have been confirmed to be serious problems to tune the electronic characteristics that affect the photocatalytic activity. Besides, activation strategies have drawn wide consideration because of their environmentally friendly nature. Photocatalysis coupled with activation approaches could definitely enhance the production of more reactive oxygen species (ROS) and the efficiency of visible light utilization. Present review article proposed a discussion on the different activation strategies and their possible reaction pathways that contribute to the mineralization mechanisms of distinctive antibiotics. Firstly, the comparison and estimation of the band gap with the redox capability of different photocatalysts and the activation mechanism of persulfate, peroxymonosulfate, hydrogen peroxide and ozone are introduced and compared. Then the efficiency and the potential removal mechanisms of different classes of antibiotics with binary and multi-component bismuth-based metal oxides and composites are summarized and evaluated. Finally, the present challenges and potential applications of bismuth-based composites in photocatalysis chemistry of antibiotic degradation are summarized.