In recent years, concern around the impact of pharmaceuticals and personal care products (PPCPs) on the environment has grown. In order to investigate the influence of tourists on emissions and ecological risk of PPCPs, the concentrations of thirty PPCPs were measured in influent and effluent from the four largest wastewater treatment plants, as well as surface river water at six sites in a famous tourist city (Sanya City, China). Substantial increasing trends on PPCPs levels were observed from low to high tourist season (ng/L to µg/L, or µg/L to mg/L). Caffeine (CAF) was dominant with concentrations as high as 185 µg/L. Emission load per capita was estimated to explore the contribution of different populations. Tourist migrant population might be a dominant contributor, as they were mostly elderly people who took long-term medication. The predicted no-effect concentration was derived using the species sensitivity distribution method to calculate the ecological risk quotient (RQ) of the dominant PPCPs. Additionally, RQs of seven dominant PPCPs in rivers were > 1, indicating high chronic ecological risk for freshwater ecosystems. The results of this study will assist in raising the awareness and improving management of emerging pollutants in less industrialized regions.