Although　the　combined　pollution　of　trace　elements　and　antibiotics　has　received　extensive　attention,　the　fate　and　toxicity　risk　of　trace　elements　with　high　antibiotic　risk　are　still　unclear.　The　multimedia　distributions,　partitioning,　sources,　toxicity　risks　and　co-occurrence　network　characteristics　of　trace　elements　in　surface　water　(SW),　overlying　water　(OW),　pore　water　(PW)　and　sediment　(Sedi)　samples　of　61　sites　from　Baiyangdian　(BYD)　Lake　were　investigated.　The　trace　elements　in　the　SW　and　OW　are　derived　mainly　from　traffic　and　agricultural　sources,　and　those　in　PW　and　Sedi　samples　are　primarily　from　lithogenic　and　industrial　sources.　The　total　toxicity　risk　index　(TRI)　of　nine　trace　elements　(ΣTRI)　in　Sedi　samples　showed　a　very　high　toxicity　risk　(18.35　±　8.84),　and　a　high　combined　pollution　toxicity　risk　(ΣΣTRI)　was　observed　in　PW　(149.17　±　97.52)　and　Sedi　samples　(46.37　±　24.00).　The　co-occurrence　network　from　SW　to　PW　became　more　vulnerable.　Generally,　total　antibiotics　and　TP　may　be　keystones　of　trace　elements　in　water　and　sediment.　The　high　antibiotic　risk　significantly　influenced　ΣΣTRI　in　water　samples　but　not　in　Sedi　samples.　The　findings　provide　new　implications　for　the　monitoring　and　control　of　combined　antibiotic-trace　element　pollution　in　shallow　lakes.　©　2024　Elsevier　B.V.