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Membrane bioreactor (MBR) has shown promising results in the abatement of pharmaceuticals, however, its fouling propensity has continued to put challenges in its wide-scale applicability. The present study is the first study that investigated the MBR fouling behaviour in the presence of iodinated X-ray contrast media (ICM). The study found that ICM aggravated the fouling issue by reducing the filtration cycle by 21 % and enhancing the production of key foulants- extracellular polymeric substances (EPS) and soluble microbial products (SMP). Size exclusion chromatography (SEC) results revealed the presence of a higher molecular weight (MW) organics in the EPS in ICM dosed phase. Also, excitation-emission matrix (EEM) contours of EPS showed that the exposure to ICM seemed to stimulate the secretion of aromatic proteins comprising tryptophan (28.7 %) and tyrosine (22.07 %) compared to the non-ICM …