Chitosan has received widespread attention as an adsorbent for pollutants because of its low cost and great adsorption potentials. Chitosan has abundant hydroxyl and amino groups that can bind heavy metal ions. However, it has defects such as sensitivity to pH, low thermal stability, and low mechanical strength, which limit the application of chitosan in wastewater treatment. The functional groups of chitosan can be modified to improve its performance via crosslinking and graft modification. The porosity and specific surface area of chitosan in powder form are not ideal, therefore, physical modification has been attempted to generate chitosan nanoparticles and hydrogel. Chitosan has also been integrated with other materials (e.g. graphene, zeolite) resulting in composite materials with improved adsorption performance. This review mainly focuses on reports about the application of chitosan and its derivatives to remove different heavy metals. The preparation strategy, adsorption mechanism, and factors affecting the adsorption performance of adsorbents for each type of heavy metal are discussed in detail. Recent reports on important organic pollutants (dyes and phenol) removal by chitosan and its derivatives are also briefly discussed.