Intensive irrigated horticulture in the Loukkos Basin (north-western Morocco) combines high pesticide pressure with wetlands of international importance, yet the evidence linking pesticide use, exposure and effects has not been examined as a chain. This narrative review, based on a structured literature search covering January 2008 to May 2026, examines each link for the Loukkos and uses data from the Gharb, Saïss and Tadla perimeters only as comparative context. Pesticide pressure was described with the number of treatments (NT), the treatment frequency index (TFI) and the quantity of active substance per hectare per year (QASI). Loukkos TFI values range from 14.94 (groundnut) to 28.46 (watermelon); they are higher than the few values reported for comparable crops elsewhere, but differences in samples, periods and reference doses preclude a strict ranking. Measured environmental data come from single campaigns: 16 active substances in 11 farm wells (dichlorvos up to 11.0 μg/L in one sample), 11 residues in 12 soil samples and eight pesticides in river water. Earthworm risk quotients (maxima 26.2 and 46.8) are calculated indicators, not observed effects. No study has measured worker exposure or health outcomes in the Loukkos, or pesticides in the drainage canals that flow into a Ramsar wetland. High treatment intensity therefore indicates a potential for exposure, which measurements have confirmed only for groundwater, soil and river water. The review separates what is measured, what is calculated, what is inferred from international studies and what remains assumed.