Matrix effects that occur during quantitative measurement by liquid chromatography mass spectrometry specifically when using electrospray ionization are a widely recognized phenomenon. Sample matrix compounds affect the ionization process of the target analytes, lead to a low signal response, and flawed analytical results. How these matrix compounds directly influence the ionization process has not yet been completely understood. In the present study, we determined the matrix effect for 33 pharmaceutical substances in sample extracts of urine, plasma and wastewater. Most of the investigated substances were subject to a signal suppression effect. Only for a small subset of the compounds we detected a signal enhancement effect. We investigated the matrix effect profiles in detail to disentangle the influence of different matrices and to correlate the impact of specific components and groups of the analyzed extract in suppressing or enhancing effects in the profile.Most signal suppression effects were detected in the first half of the chromatographic run-time for the matrix extracts of urine and wastewater. The observed effects are caused by high mass flow of salts and other diverse matrix components that were contained in high concentrations in those biological matrices. We also found signal suppression in the matrix effect profile of plasma samples over a wide time range during the chromatographic separation that were associated with a high content of triglycerides of diverse carbohydrate chain lengths. Here, we provide a broader picture of how 33 substances were influenced during analysis. Our results imply that a high number of the investigated substances had comparable effects of matrix compounds, despite differences in their chemical structure.