Tea waste was carbonized at 400 °C for 45 min and modified with potassium hydroxide (KOH), to enhance the active sites for the adsorption of antibiotics. The developed tea waste activated carbon (TWAC) was used as a novel eco-friendly and cost-effective adsorbent for metronidazole (MZN) removal from aqueous solution. The textural and surface properties of the adsorbent were determined using Brunauer-Emmett-Teller (BET) and FT-Raman analysis. The BET surface was found to have increased from 24.670 to 349.585 after carbonization and KOH modification. The batch experimental parameters were optimized and equilibrium time was found to be 75 min. Linear and non-linear models were carried out on the adsorption isotherm and kinetics to determine the best fit for the adsorption data. The adsorption equilibrium data were well fitted by the Freundlich isotherm and pseudo-second order models, with higher regression correlation (R2) and smaller chi-square (χ2), as predicted by the non-linear model. The thermodynamic results revealed the adsorption of MZN as spontaneous, physical, and consistently exothermic in character. The activation energy value of 7.610 kJ/mol further revealed that the adsorption process is dominated majorly by physical adsorption. The removal of MZN onto TWAC was best described by the non-linear adsorption isotherm and kinetics model.