Per- and polyfluoroalkyl substances (PFASs) in peri-urban shallow lakes have attracted increasing scientific attention due to their complex environmental behavior and potential health risks. This study investigated the occurrence, bioaccumulation, and trophic magnification of 15 PFASs in water and tissues (muscle and viscera) of 11 fish species from Luoma Lake (a representative peri-urban shallow lake in eastern China), and conducted a preliminary human health risk assessment associated with fish consumption. Results showed that nine PFASs were detected in surface water (∑PFASs: 58.80~90.59 ng/L), while all 15 target compounds were present in both muscle and visceral tissues (∑PFASs: 166.59~417.65 ng/g dw in muscle; 76.04~897.83 ng/g dw in viscera). PFBA, PFOA, and PFHpA were the predominant congeners in water, muscle, and viscera, respectively. PFASs exhibited pronounced tissue-specific accumulation, with concentrations following the order: kidney > liver > gill > muscle > intestine > brain, indicating preferential enrichment in excretory and metabolic organs. A significant urban-rural gradient was observed: PFASs concentrations in muscle, kidney, liver, and gill of fish from urban zone were significantly higher than those from rural zone, whereas no significant differences were found in brain and intestine. Long-chain PFASs generally displayed higher bioaccumulation factors (BAFs) than short-chain analogues. Trophic transfer analysis revealed that long-chain PFASs underwent significant biomagnification (trophic magnification factor, TMF > 1), whereas short-chain PFASs tended to be biodiluted (TMF < 1). Health risk assessment indicated that current dietary exposure to PFASs via consumption of Luoma Lake fish is within acceptable limits (HR < 1). Nevertheless, potential risks from long-term low-dose exposure and the relatively high cumulative toxicity in rural zones warrant further attention. These findings provide valuable insights into the environmental fate, ecological effects, and health risk management of PFASs in peri-urban shallow lake ecosystems.