The wide application and low utilization rate of oxytetracycline (OTC) make it often detected in wastewater, which may cause harmful effects on microbial denitrification. Aerobic denitrification (AD) as a new microbial denitrification technology has obvious advantages. However, systematic studies on the effects of OTC on it are lacking. In this study, the effect of OTC on AD was comprehensively explored from multiple perspectives, the main results are as follows. From the perspective of bacterial performance, OTC inhibited AD bacteria growth, denitrification efficiency, and caused serious damage to cell morphological structure, results of CCK-8 confirmed that bacterial activity was significantly affected. From the perspective of electron behavior, OTC decreased electron-producing capacity of carbon metabolism, reduced activity of the electron transport system, inhibited the electron consumption of NAR and NIR to varying degrees, thus increased the risk of nitrite accumulation. From the perspective of intracellular environment, OTC broke redox balance and antioxidant mechanism, related carbon and nitrogen cycle functional genes were down-regulated, affected amino acid, organic acid and nucleotide metabolic processes. The above results provide important information for evaluating the potential risks of antibiotics on the application of AD, and provide key background and theoretical support for stabilizing the technology.