Organic dye and antibiotic residues are some of the key substances that can contaminate the environment due to their wide usage in various industries and modern medicine. The degradation of these substances present in waterbodies is essential while contemplating human health. Photocatalysts (PSs) are promising materials that develop highly reactive species instantly by simple solar energy conversion for degrading the organic dye and antibiotic residues and converting them into nontoxic products. Among numerous semiconductors, the bismuth (Bi)-containing PS has received great attention due to its strong sunlight absorption, facile preparation, and high photostability. Owing to the technology advancement and demerits of the traditional methods, a Bi-containing direct Z-scheme PS has been developed for efficient photogenerated charge carrier separation and strong redox proficiency. In this review, a synthetic Bi-based Z-scheme heterojunction that mimics natural photosynthesis is described, and its design, fabrication methods, and applications are comprehensively reviewed. Specifically, the first section briefly explains the role of various semiconductors in the environmental applications and the importance of the Bi-based materials for constructing the Z-scheme photocatalytic systems. In the successive section, overview of Z-scheme PS are concisely discussed. The fourth and fifth sections extensively explain the degradation of the organic dyes and antibiotics utilizing the Bi-based direct Z-scheme heterojunction. Eventually, the conclusions and future perspectives of this emerging research field are addressed. Overall, this review is potentially useful for the researchers involved in the environmental remediation field as a collection of up-to-date research articles for the fabrication of the Bi-containing direct Z-scheme PS.