The removal of 12 pharmaceuticals and personal care products (PPCPs) in two full-scale wastewater treatment plants (WWTPs) and a tertiary treatment system was studied. The ecological risks of effluents from both secondary and tertiary treatment systems as well as excess sludge were evaluated. Primary treatment and ultraviolet light disinfection showed limited ability to remove most selected PPCPs. The combination of an anaerobic process and triple-oxidation ditches can eliminate DEET better than the anaerobic/anoxic/oxic process. Adsorption to sludge played a key role in the removal of triclocarban. Multistage constructed wetlands as a tertiary treatment efficiently removed caffeine and ibuprofen from wastewater and could decrease the risk of partial selected PPCPs. Selected PPCPs residues in excess sludge generally produced higher risks to the ecological environment than effluents from WWTPs.