Urbanization and industrial growth have negatively impacted water quality, raising concerns about emerging aquatic pollutants. Despite advancements in water treatment, these substances persist, endangering aquatic life and human health. Although research has focused on the physiological effects of these pollutants, their genetic damage potential remains poorly understood. This systematic review aimed to consolidate existing knowledge on the genotoxic potential of emerging aquatic pollutants. A comprehensive search was conducted across major databases, encompassing articles published from 2001 to 2022. The review primarily focused on research articles that evaluated genotoxicity in environmental samples containing emerging pollutants, as well as in vitro studies using various concentrations of these substances. Fourteen articles were included in the review, with pharmaceutical compounds, personal care products, disinfection by-products, and industrial chemicals being the most extensively investigated classes. Other notable pollutants included metals, cyanotoxins, antiseptics, pesticides, and caffeine. All these pollutants classes were found to cause DNA damage, either in vitro at specific concentrations or in complex environmental mixtures. The comet assay was the most frequently used method, owing to its sensitivity and practicality in assessing DNA damage. For some pollutants, different responses were observed when comparing in vitro and in vivo studies, emphasizing the need for studies employing both approaches. However, the limited number of available articles underscores the necessity for further research on the genotoxic potential of emerging pollutants. More research is required to clarify mutagenicity, DNA repair kinetics, and cumulative effects of pollutants, which are critical for shaping policies and ensuring safe water quality. A greater knowledge about these pollutants will enable better understanding risk mitigation, ultimately protecting public health and ecosystems.