Acetaminophen (N-acetyl-p-aminophenol, APAP) is one of the most common antipyretic analgesics used to treat common ailments throughout the world. Recently, APAP has been frequently detected in wastewater effluent and groundwater, resulting in potential risks to the environment. Current methods for eliminating APAP are complicated and cost-prohibitive. This study examined APAP degradation by ultraviolet-C (UV-C) and UV-C irradiation combined with activated sludge (UV/AS) to evaluate potential applications in wastewater treatment. The results of this study indicate that UV-C irradiation reached an APAP degradation efficiency of more than 52% and a degradation rate of 0.0012–0.0013 min−1 during 720 min of exposure, while the initial APAP concentration exhibited only a nominal effect on the degradation rate. However, the UV/AS treatment demonstrated an APAP degradation rate that was 9.6 times the rate of the UV-C-only treatment, with a degradation efficiency of 99% over the same UV irradiation period. The results further indicated that APAP photolysis efficiency was more effective when applied to sterilized AS than when applied to unsterilized AS. Finally, excessive dosage of both AS and humic acid inhibited APAP photolysis efficiency.