Carbamazepine (CBZ) is an antiepileptic drug which is persistent in wastewater treatment plants and the environment. It has been frequently detected in plant material after irrigation with treated wastewater. To date, little information is, however, available on the transformation of CBZ in plants. In the present study, the uptake, translocation, and transformation of CBZ was studied in hydroponically grown tomato plants. After 35 days of exposure >80% of the total spiked amount of CBZ was taken by the tomato plants and mainly stored in the leaves. A total of 11 transformation products (TP) (mainly phase-I) were quantified by liquid chromatography–tandem mass spectrometry (LC-MS/MS) and their total amount corresponded to 33% of the CBZ taken up. The ratio of CBZ metabolites to CBZ was highest in fruits (up to 2.5) and leaves (0.5), suggesting an intensive transformation of CBZ in these compartments. Further 10 TPs (phase-I and II) were identified by LC-high resolution mass spectrometry screening, likely comprising another 12% of CBZ. On the basis of these experiments and on an experiment with CBZ-10,11-epoxide a transformation pathway of CBZ in intact tomato plants is proposed that involves epoxidation, hydrolysis, hydroxylation, ring contraction, or loss of the carbamoyl group, followed by conjugation to glucose or cysteine, but also reduction of CBZ. This transformation pathway and analytical data of CBZ transformation products allow for their determination also in field grown vegetable and for the generation of more accurate exposure data of consumers of vegetable irrigated with treated municipal wastewater.