Pollution resulting from the combination of antibiotics and heavy metals (HMs) poses a significant threat to human health and the natural environment. Adsorption is a promising technique for removing antibiotics and HMs owing to its low cost, simple procedures, and high adsorption capacity. In recent years, various novel carbon nanomaterials have been developed, demonstrating outstanding performance in simultaneously removing antibiotics and HMs. This work presents a comprehensive review of carbon nanomaterials (i.e., carbon nanotubes, graphene, resins, and other nanocomposites) for the co-removal of antibiotics and HMs in water systems. The mechanisms influencing the simultaneous removal of antibiotics and HMs include the bridging effect, electrostatic shielding, competition, and spatial site-blocking effects. These mechanisms can promote, inhibit, or have no impact on the adsorption capacity for antibiotics or HMs. Additionally, environmental factors such as pH, inorganic ions, natural organic matter, and microplastics affect the adsorption efficiency. This review also covers adsorbent regeneration and cost estimation. On the laboratory scale, the cost of the adsorption process primarily depends on the chemical and energy costs of adsorbent production. Our assessment highlights that the carbon-nanomaterial-mediated simultaneous removal of antibiotics and HMs warrants comprehensive consideration from both economic and environmental perspectives.