Antibiotics　are　widely　found　in　aquatic　ecosystems　and　pose　a　serious　threat　to　human　and　the　ecological　system.　Samples　of　surface　water　(SW),　overlying　water　(OW),　pore　water　(PW)　and　sediments　(Sedi)　were　collected　to　investigate　the　spatial　variability,　potential　sources,　ecological　risk　(RQs)　and　health　risks　(HQs)　of　nine　common　antibiotics　in　Baiyangdian　Lake　using　positive　matrix　factorization　(PMF),　and　Monte　Carlo　simulation.　Significant　spatial　autocorrelation　of　most　antibiotics　were　observed　in　PW　and　Sedi　samples　rather　than　in　SW　and　OW　samples,　and　higher　antibiotic　levels　were　found　in　the　northwest　of　waters　and　the　southwest　of　sediments.　Livestock　(26.74–35.57%)　and　aquaculture　(21.62–37.70%)　were　identified　as　primary　sources　of　antibiotics　in　the　water　and　sediments.　Norfloxacin　and　roxithromycin　showed　high　levels　of　RQ　and　HQ　in　more　than　50%　of　samples,　respectively.　The　combined　RQ　(ΣRQ)　in　the　PW　can　be　used　as　a　sign　of　across　multimedia　risk.　Notably,　appreciable　health　risks　were　observed　for　the　combined　HQ　(ΣHQ)　in　about　80%　of　samples,　indicating　the　importance　of　taking　health　risk　of　antibiotics　into　consideration.　The　findings　of　this　work　provides　a　reference　for　antibiotics　pollution　control　and　risk　management　in　shallow　lake.　©　2023　Elsevier　B.V.