The increasing occurrence of antibiotic residues in aquatic environments poses significant risks to ecosystem integrity and public health, necessitating the development of rapid, sensitive, and portable analytical technologies. Herein, a MXene-supported dual single-atom Fe–Co nanozyme nanocomposite (FeCo-SA/MXene) is proposed as a high-performance electrocatalytic platform for the ultrasensitive electrochemical detection of antibiotic contaminants in water. The nanocomposite integrates the exceptional electrical conductivity and abundant surface functionalities of Ti₃C₂Tₓ MXene with atomically dispersed Fe–N₄ and Co–N₄ catalytic sites, enabling accelerated electron transfer and enhanced electrocatalytic activity. The structural characterization confirmed successful formation of isolated Fe–Co active sites without detectable metal nanoparticles, while electrochemical impedance spectroscopy indicated a substantial reduction in charge-transfer resistance from 185 Ω for the bare glassy carbon electrode to 26 Ω after FeCo-SA/MXene modification, accompanied by a 3.5-fold increase in electrochemically active surface area. The proposed sensor exhibited wide linear detection ranges of 0.5 nM–100 μM for tetracycline, 1 nM–80 μM for ciprofloxacin, 2 nM–100 μM for sulfamethoxazole, and 5 nM–120 μM for chloramphenicol, with corresponding detection limits of 0.12, 0.28, 0.45, and 0.83 nM, respectively. The sensor further demonstrated excellent selectivity against common interfering species, retained 96% of its initial response after 30 consecutive measurements and 94% after 4 weeks of storage, and achieved recoveries of 95.9–103.1% with relative standard deviations below 3.5% in environmental water samples. These findings demonstrate the potential of FeCo-SA/MXene nanozyme nanocomposites as a promising platform for developing next-generation electrochemical sensors for rapid, ultrasensitive, and reliable monitoring of emerging antibiotic contaminants in aquatic environments.