As one of the world’s largest developing countries, China is facing an increasingly severe pollution problem caused by phthalates (PAEs). PAEs are widely used as plasticizers in various industries, including the food and pharmaceutical industries. Due to their widespread use and the lack of standardized treatment, they have accumulated in the environment over the long term and have become highly toxic. This study systematically analyzed the occurrence, spatial distribution, ecological risks and potential sources of PAEs in 30 typical lake water bodies and 20 typical lake sediment samples in China to explore the occurrence characteristics of PAEs and the effects of human activities. The results indicated that the concentration range of PAEs in the aqueous and sediment phases was 0.01-27.6 μg/L and 28.8-74935 ng/g, respectively. Di (2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP) were the predominant PAEs in both phases. The spatial distribution of lake areas showed significant differences, with the most severe pollution occurring in the middle and lower reaches of the Yangtze River. DEHP and DBP were found to be the main PAEs in lake water and sediments, contributing the most. There were significant differences in the spatial distribution of lake areas, with those in the middle and lower reaches of the Yangtze River being the most severely polluted. Based on an ecological risk assessment using risk quotients, approximately 30% of lakes were found to pose a high risk to crustaceans, primarily due to the presence of DEHP and DBP. Further principal component analysis and multiple linear regression revealed that industrial wastewater discharge and agricultural production activities were the primary sources of PAE pollution. There was a significant positive correlation between the use of agricultural films and pesticides, and DEHP and DBP concentrations. The results of the study indicate that PAEs exhibit significant multi-media distribution characteristics in the lake water-sediment system and are profoundly influenced by human activities. Therefore, the management of PAE additives in agricultural production should be strengthened, and the efficiency of PAE removal in industrial wastewater treatment processes should be improved, in order to reduce the pollution load of lake water bodies. This study reveals the environmental behavior, risk characteristics and anthropogenic driving mechanisms of PAEs in typical Chinese lakes, providing a scientific basis for formulating water ecological and environmental protection strategies.